2017 Vacation Bible School Registration
June 4-8, 6:00-8:30p
2300 Cadiz Rd.
(270) 886-4461 or info@edgewoodbaptistchurch.org
Email address *
Contact Information
Parent/Guardian Name *
Your answer
Address *
Street Address, City, State, Zip Code
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
Primary Email *
Your answer
Secondary Email
Your answer
Child's Name *
Your answer
Age Information
Child's Birth Date
Your answer
Child's Age *
Your answer
Last Grade Completed In School *
Your answer
Medical Information
Emergency Contact(s) Name & Phone Number *
You may enter more than one.
Your answer
Dismissal Information
Who May Pick Up Your Child at the end of each VBS day? *
Your answer
Other Information
May we have permission to photograph your child? *
Required
Will your child need to ride our bus? *
A copy of your responses will be emailed to the address you provided.
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