CEC in Livingston VBS 2019 Registration
Christian Evangelical Church in Livingston - 71 Old Road Livingston NJ 07039
2019 Vacation Bible School Registration
August 5, 2019 (Mon) to August 9, 2019 (Fri) from 8:45 am to 12 noon
Age Group (Kindergarten to Grade 6 - for Fall Attendance)
Last Name *
Your answer
First Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
Age *
Your answer
Birthday *
MM
/
DD
/
YYYY
School grade child will attend in the Fall *
Home Phone *
Your answer
Parent Cell Phone(s) *
Your answer
Parent Email *
Your answer
Parent(s) name(s) *
Your answer
Parent(s) work phone(s) *
Your answer
In case of emergency, contact NAME and PHONE *
Your answer
Allergies or other medical conditions
Your answer
Name of home church, if any
Your answer
Special Notes
Any other information you would like us to know
Your answer
Name of Parent/Legal Guardian filling out this registration *
Your answer
I hereby grant permission for video recording and digital photographs to be taken of my child or my child’s work as part of his/her participation in the Christian Evangelical Church in Livingston Vacation Bible School. I understand that the recordings and images collected maybe used in publications, including electronic publications, audio visual presentations, promotional literatures, church websites,social medias and other similar ways. We will keep it anonymous and not identify any child by name.
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