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REGISTRATION FORM
VACATION BIBLE SCHOOL -
2011
| VACATION BIBLE SCHOOL
-Scheduled for June 13 - 17, 5:30 PM - 8:00 PM. Dinner will be
served each night. Freewill offering See Amy Onkka for details or
call 505-7735 (weekdays) or 529-4863 (cell)
Want more information on the
curriculum? Click
here.
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EACH CHILD MUST BE REGISTERED SEPARATELY!
nter the event:
Child's Name:
Last School Grade Completed:
Child's Date of Birth:
Child's Age:
Home Address:
Home Phone:
Alternate Phone
Emergency Contact Person
Emergency Contact Relation To Child:
Emergency Contact Home Phone:
Emergency Contact Alternate Phone:
Food Allergies (Yes or No, if Yes, list)
Medical Concerns (Yes or No, if Yes, Explain)
Family Doctor
Family Doctor's Phone
Siblings Attending VBS, Names and Ages
Parents:
Parents Address - City, State Zip:
Home Church:
Your email address:
People Who May Pick Up The Child:
EACH CHILD MUST BE REGISTERED SEPARATELY VBS
leaders have permission to photograph/film the minor designated above in
any manner or form for any lawful purpose associated with this VBS
program.
Thank you for registering.
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