Online Registration PLC - VBS
Dates - June 11, 2018 - June 15, 2018
Parent/Guardian Information
Parent/Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email Address
Your answer
Child's Last Name *
Your answer
Child's First Name *
Your answer
Age *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Grade Completed *
Allergies *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Number *
Your answer
Permission Slip
Please print off permission slip and return to church office by first day of VBS.
Submit
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