VBS 2017…

 

SIGN-UP TODAY FOR VBS 2017!

JUNE 19-23

9 A.M. – NOON

(for Children *3-years-old through Grade 5)
*Must be potty trained
 
 

Your Name (required)

Your Email (required)

Child's Name

Child's Age

Date of Birth

Grade Finished

Address

City

Zip

Parents/Guardians Names

Phone

Do you attend church?
yesno

If so, which church...

Emergency Contact Name and Phone

Allergies

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