VBS Registration FormJune 17-21, 20186:00pm-8:00pm

Please return your registration form to the church office.(Complete a form for each child you are registering)

Child’s Name:__________________ Gender:____ Grade Entering:_____

Address:___________________________________________________

Parent Name:_____________________ Home Phone:______________

Cell Phone:________________ Parent Email:______________________

Emergency Contact Name:________________ Relationship:_________

Emergency Contact Phone Number:_____________________________

Food or drug allergies/any special dietary or physical need we should know:_________________________________________________________________________________________________________________________________________________________________________