Vacation Bible School

Vacation Bible SChool 2022
JUNE 27 - JULY 1
Registration

* Indicates required field

Childs Name *

First

Last

Parent / Guardian *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone *

Work Phone *

Cell Phone *

Email *

Birthdate *

Last grade completed *

Medical Information - Allergies - If not, enter "none" *

Emergency Contact 1 *

First

Last

Phone Number *

Emergency Contact 2 *

First

Last

Phone Number *

Does your child attend Sunday School? If so, where? *

May we have permission to photograph your child? *

Yes No

May we have permission to use your child's photograph for the purpose of promotion? *

Yes No

Additional Comments *

Submit