Vacation Bible School
Registration
June 04-08, 2018
Child’s Name: 
Parent/Guardian Name:
Address:
Home Phone:
Cell Phone:
Date:
Birth Date:
Last grade completed:
Medical or other info we need to know:  (Please include any FOOD ALLERGIES)
Dismissal Information:  Who may pick up your child at the end of VBS night?
Name:
Phone:
Name:
Phone:
Emergency Contacts:
Do you attend Sunday School?
Where?

Age:
For children age 4 through 6th grade.