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Hesston Community Vacation Bible School Registration Form
Bible School will be the week of June 8-12. Pre-registration by May 31 is requested to help with planning, but not required. See flier for locations and times.
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* Indicates required question
Name
*
Your answer
Gender
*
Male
Female
Birthdate
*
Your answer
Grade During 2014-2015 School Year
*
Your answer
Age
Your answer
Parent's Name
*
Your answer
Address
Your answer
City and State
Your answer
Zip
Your answer
Parent's Phone
*
Your answer
Cell Phone
Your answer
Emergency Contact Phone
*
Your answer
Allergies (Food, Insect, etc.)
Your answer
Diabetes/Special Needs (Anything we need to know)
Your answer
Attend Church at (If applicable)
Your answer
I give my permission for my child's photo to be taken. I understand that no names or other identifiable information will be used in publications.
*
Yes
No
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