Vacation Bible School Registration

June 17-21; 9 a.m. - 12 p.m.
For Children Who Have Completed Kindergarten Through Fifth Grade

Please complete the form below

For each line, list each child's name, date of birth and last grade completed.
Please include any food allergies
Parent/Guardian Name *
Parent/Guardian Name
Address *
Address
Phone *
Phone
Name and number
May we have permission to photograph your child and use your child's photograph in church publications for purpose of promotion? *