Vacation Bible School
Registration
Parent/Guardian information
Name:
Address:
City, State Zip:
,
Home Phone:
Cell Phone:
Email:
Child information
Name:
Age:
Date of Birth:
/
/
(mm/dd/yyyy)
Gender:
Male
Female
Last Grade Completed:
Alergies or Medical Needs:
Emergency information
Name:
Phone:
Realtionship:
Person responsible for picking up child
Name:
Phone:
Additional information
Anything you'd like us to know about your child:
Special needs/circumstances:
One friend my child would like to be with:
Would you like to volunteer as:
Site Guide
Assistant
Registrar
Other
Days available:
