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VBS 2019 Registration

GOD & ME @SEA

July 1 - July 3

Please use a separate form for each child. $57/child

9am-3pm

9am-12pm (rising Pre-Ks)

Child's Name

*

First Name

Last Name

Payment: $57

*

$

Child's T-shirt Size

XS (2-4)

S (6-8)

M (10-12)

L (14-16)

Adult (S)

Child's birthdate

*

Grade in Sep '19

Parent/Guardian Name/s

*

First Name

Last Name

Cell Phone

Parent/Guardian Name/s

First Name

Last Name

Cell Phone

Best email to use:

*

Verify Email

*

Medical Information

Tell us medical or other information we need to know. Please include food allergies & instructions.

Emergency Contact

Emergency Contact Name (if different from above)

First Name

Last Name

Emergency Contact Phone

Name of person picking up at dismissal

First Name

Last Name

Cell Phone

If you are visiting our church, how did you hear about us?

May we use your child's photograph for in-house church promos?

Yes

No