Epiphany VBS Registration Form
Join us for Monumental Vacation Bible School June 27-29 from 9:30-11:30am.  If you are new to our church, please plan to stay with your child the first day (or more if you wish).

Vacation Bible School is open for all children age 5 - rising 6th grade.

To register, fill out this form. If you have any questions contact Rev Cynthia in the church office at 615-444-7336 or email revcynthia@epiphanytn.com.

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Child's Name (First and Last Name)
Child's Age
Completed grade 2021-2022
#2 Child Name (First and Last Name) If registering more than one child.
Child's Age
Completed grade 2021-2022
#3 Child's Name (First and Last Name) If registering more than two children.
Child's Age
Completed grade 2021-2022
#4 Child's Name (First and Last Name) If registering more than three children.
Child's Age
Completed grade 2021-2022
Address
Parent/ Guardian Name
Parent/ Guardian Phone number
Parent/ Guardian Email Address
Participant's Date of Birth
MM
/
DD
/
YYYY
Emergency Contact and Phone  Number
Special Concerns/ Allergies/ Medical Conditions
Where do you attend church?
Authorized Adults to Pick up from VBS, Name and relationship to child
Photo Release (My child has consent to have his/her picture taken and/or used in VBS publications)
Participants T-shirt Size
Submit
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