Vacation Bible School ( with registration )

How did you hear about this year's VBS?

A Friend

Flyer in the Mail

Electronic Sign

Email Invitation

Facebook

Instagram

Website

Parent/Guardian Name: *

*

Email Address *

Phone Number (include area code) *

If there is someone else to contact in an emergency, please indicate their name and phone number here:

Child's Name (#1) - additional children can be listed below *

Child's Age (#1) *

Any special allergies we need to be aware of for this child? (#1) - If 'Yes' please indicate

Child's Name (#2)

Child's Age (#2)

Any special allergies we need to be aware of for this child? (#2)

Child's Name (#3)

Child's Age (#3)

Any special allergies we need to be aware of for this child? (#3)

Child's Name (#4)

Child's Age (#4)

Any special allergies we need to be aware of for this child? (#4)

Please list any additional adults authorized to pick up your child(ren):

Other notes/comments we should be aware of?

Thank you for registering. Your information has been sent.

There was an error trying to register. Please check your form for any potential errors or missing information.

Vacation Bible School

Monday July 27 to

Friday July 31