Calling all children ages 5-13 to register for this exciting event from 15-Jun to 17-Jun for a fun filled experience through Keepers of the Kingdom

Vacation Bible School Registration

(One form per child)

Child's Name* Birthday*
Grade Completed* T Shirt Size
Father's Name* Home Phone*
Mother's Name* Mother's Phone
Home Address* Preferred Email*
Food Allergies* List all the Food allergies (if any)
Medical Concerns* List all medical concerns (if any)
Family Doctor's Name Doctor's Contact
People who may pickup the child Transportation Required*
Church Affiliation Church Membership At (if any)
* I agree VBS coordinators have permission to film or take photographs/video of my child