2017 VBS Registration
Event Timing: 9-noon, Mon-Fri, July 17-21, 2017
Event Address: New Hope, 664 E 16th St in Sedalia
Contact us at (660)826-6277 or nhbcsedalia@swbell.net
Child's name
Your answer
Date of Birth
Your answer
Age/Grade completed in school
Your answer
Parent/Guardian Names
Your answer
Address
Your answer
Phone Number
Your answer
E-mail Address
Your answer
Emergency Contact
Your answer
Allergies/ Medical Information
Your answer
Other siblings attending? Please include names, ages & grades
Your answer
Transportation information
If you checked "Needs a Ride" please indicate pick up and drop off address if different
Your answer
If you checked "Car Rider" who will pick up your child each day
Your answer
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