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Vacation Bible School

l	August 3-7, 2009

This summer's Vacation Bible School will ROCK!!! Be sure to register your child early. **Ages 3 through grade 5 as of August 31, 2008.**

* Required

First Name *

Last Name *

Email Address *

Birthday *

Address Line 1 *

Address Line 2

City *

State *

ZIP Code *

Home Phone *
( ) - ext.

Mobile Phone
( ) - ext.

What is the child's age? *

Allergies: *

Preschool Class/Grade completed: *

Where? *

FBC church member? *
Yes
No

Number of siblings attending?

Sibling Name(s) and Age(s)

Parent(s) Name *

Parent(s) Daytime Phone *

Parent(s) location during VBS *
On-site
Off-site

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

In the unlikely event of a medical emergency in which we cannot be reached, permission is hereby given to First Baptist Church to transport my child to the hospital for medical treatment. *
Yes
No

While there are no guarantees, if you would like your child to attend a particular class with another participant, please indicate that child's name and grade. Every effort will be made to accommodate the request

Last Published: June 18, 2009 12:34 PM

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