ROAR VBS REGISTRATION
St. John-Hill UCC
Sunday - Wednesday, June 9-12, 2019
6-8 PM ***NOTE NEW TIME***
Child's Name *
Your answer
Gender *
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Parent's Name(s) *
Your answer
Phone # *
Your answer
E-mail *
Your answer
Child's Birthday *
MM
/
DD
/
YYYY
Age (as of June 9, 2019) *
Your answer
Grade Completed as of June 2019 *
Home Church
Your answer
Allergies or Medical Conditions *
Your answer
Emergency Contact (other than parent(s)) Name *
Your answer
Emergency Contact Phone # *
Your answer
Emergency Contact Relationship to Child *
Your answer
Child's Shirt Size *
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