Vacation Bible School 2018

Child's Name

Parent/Guardian Name

Address

Phone Numbers:

Home

Work

Cell

This address will receive a confirmation email

Age

Last Grade Completed In School

Medical or other information we need to know. (Please include any food allergies)

Emergency Contact(s):

Name & Phone Number

Dismissal Information:

Who may pick up your child at the end of each VBS day?

May we have permission to photograph/film your child during VBS to use for the purpose of promotion?

Yes No

Description

July 23-27...9:00-12:00

Please fill out this form and click submit.