VBS 2014 registration

Pre-Registrations received by May 15th. will receive a
FREE CD!
(one per family)

* Indicates required field

Name *

First

Last

Grade Entering *

Age *

Birthday *

Parents/Guardians *

Home Address *

Home Phone *

Emergency Contact person *

Cell Phone *

Emergency Phone Number *

Home Church *

Email *

Allergies or other medical conditions *

Alternate People that are allowed to pick up your child *

I give permission for my child to be photographed and videotaped during church activities. My child’s image may appear in print or online promoting the church’s activities. I understand that my child’s name will not be used to identify my child. *

Yes No

If you have questions, please call the office at 419-637-2159.
Office hours are Tues. 9-Noon and Wed. & Thurs. 9am –3pm

Submit

If you have questions, please call the office at 419-637-2159. Office hours are Tues. 9-Noon and Wed. & Thurs. 9am –3pm

If you have questions, please call the office at 419-637-2159.
Office hours are Tues. 9-Noon and Wed. & Thurs. 9am –3pm