VBS Registration

AGES: 4 year old- 5th grade 

JUNE 6th-8th   |  6:00 - 8:30 PM

Child's Name
Child's Name
Date of Birth
Date of Birth
Address
Address
Phone
Phone
Can you accept text messages?
Emergency Contact
Emergency Contact
Emergency Contact Phone
Emergency Contact Phone
PHOTO RELEASE: By filling out this form I also agree to the following release of information regarding my child: The Church may feature my child in broadcast and or print media, on the church website, and in publications and programs.
PHOTO RELEASE: By filling out this form I also agree to the following release of information regarding my child: The Church may feature my child in broadcast and or print media, on the church website, and in publications and programs.
Date
Date