VBS 2017 Vacation Bible School Registration Form
Location: Lewis Lane Baptist Church, 2600 Lewis Lane, Owensboro, KY
Church Office Phone Number: 270-684-4266
Vacation Bible School at Lewis Lane Baptist Church is June 19-23, 2017 from 6 pm-8 pm
For Children who will be completing K-5th grade.
Child's Name
Your answer
Child's gender
Your answer
Child's age
Your answer
Birth date
Your answer
What grade is student finishing May 2017
Your answer
Name of Parents
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Home Phone (or put N/A if you don't have a home phone)
Your answer
Parent/caregiver's cell phone number (or put N/A if you do not have a cell phone)
Your answer
Home/work email address (or put N/A if you do not have an email address)
Your answer
What church do you attend? (put N/A if you do not attend a church)
Your answer
Child's allergies or other medical conditions we need to be aware of. (put N/A if there is nothing we need to be made aware of.)
Your answer
In case of emergency, who should we contact?
Your answer
Emergency contact's phone number
Your answer
Emergency contact's relationship to child
Your answer
I hereby GRANT or DO NOT GRANT permission for Lewis Lane Baptist Church to use pictures of my child (child's name listed at the top of this form)
Submit
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