VBS

Join us for our VBS program from Sunday, June 23rd to Wednesday, June 26th, 6:30-8:00pm. Dinner will be provided from 6:00-6:30pm.

Additionally, mark your calendars for our community block party on Thursday, June 27th, 6:00-8:00pm.

Child's Name

First Name

Last Name

Parent/Gardian Name

First Name

Last Name

Home Phone

(###)

###

####

Cell

(###)

###

####

Work

(###)

###

####

Email

Mailing Address

Mailing Address (If Different)

Birth Date

Last Grade Completed In School

Medical Information

Emergency Contacts

Other than listed above

Dismissal Information

Who may pick up your child at the end of each VBS?

Sunday School

Does your child attend Sunday School? If so where?

Guest

Who invited you?

Photos

May we have permission to use your child’s photograph for the purpose of promotion?

Yes

No

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