Vacation Bible School Online Registration Form
"If you have more than one child, we will need a registration form for each"
Daytime
Phone #
Child's full
Name
Secondary
Phone #
1. Legal Guardian
    full Name
Child's Age
2. Legal Guardian  
    full Name
Street Name
& Number
Date of birth
Child's Grade
City, State Zip
Legal Guardian's
E-mail
Please complete all information  
on this form
Questions or comments
In the event of an emergency, and a parent cannot be reached, we need a additional contact
To complete enrollment you must
use the submit button
Emergency
Contact
 Relationship
to Child
Emergency
Phone #