2017 VBS Child Registration
Who: Kids Ages 3-12
When: July 24-28 (6PM - 8:30PM) - Kids dinner served at 6pm
Where: Centro Church 2719 S. Hampton Rd. Dallas, TX 75224
Contact us at (469) 471-6001 or r.martinez@centropeople.com
Family Information
Child First Name
Your answer
Child Last Name
Your answer
Parent First Name
Your answer
Parent Last Name
Your answer
Address
Your answer
Phone Number
Your answer
Email
Your answer
Age Information
Child's Birth Date
MM
/
DD
/
YYYY
Last grade completed in school
Your answer
Medical Information
Medical or other information we need to know. (Please include any food allergies.)
Your answer
Emergency Contacts
(other than listed above)
Names (Emergency)
Your answer
Phone Numbers (Emergency)
Your answer
Dismissal Information
Who may pick up your child at the end of each VBS day?
Name (Pickup)
Your answer
Other Information
Does your child attend Sunday School? If so where?
Your answer
May we have permissions to photograph your child?
Required
May we have permission to use your child's photograph for the purpose of promotion?
Please Fill Out One Application Per Child
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