Vacation Bible School - Covenant Community Church
Online Registration form - ONE SUBMISSION PER CHILD PLEASE
Child's last name *
Your answer
Child's first name *
Your answer
Child's age at start of VBS *
Grade just completed *
Parent/Guardian name *
Your answer
Street address *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Home phone number *
Your answer
Cell phone number
Your answer
Email address
Your answer
Emergency contact name *
Your answer
Emergency contact number *
Your answer
Medical release *
You must check the following box.
Required
Allergies
Please list any allergies for your child.
Your answer
Church affiliation
Your answer
How did you hear about us?
Your answer
Will you attend the Ice Cream Social Thursday evening of VBS? (You can still sign up during VBS!)
If you will be able to attend, how many (including you) will join us? (Please respond on one form only! - Thank You).
Your answer
Your answer
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