Gibsonburg Community Church Trinity Campus
Welcome
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Shipwrecked VBS
2016 VBS Registration
*
Indicates required field
Name
*
First
Last
Grade Entering
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3 (by Jan.1st.) & 4 years old must be potty trainied
Kindergarden
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th-8th. grade
Age
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Birthday
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Parent/Guardian Name
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Home Address
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Home Phone
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Emergency contact person
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Cell Phone
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Emergency contact phone number
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Home Church
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Email Address
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Allergies or other medical conditions
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Alternate People that are allowed to pick up your child
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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
Submit
Welcome
Media
Shipwrecked VBS