Vacation Bible School 2018 Registration

One Child per Registration Form
Child's First Name*
Child's Last Name*
Parent's First and Last Name*
Address (Street, City, and Zip)*
E-mail Address*
Phone Number*
Child's Date of Birth*
Child's Age*
Child's Grade 2017-2018 School Year*
Allergies/Medical Conditions/Other
Alternative Emergency Contact - Name and Phone Number*
Church Affiliation (optional)
T-Shirt Size for Child*