VBS Child Registration

  June 25th-29th ~  5:45-8:30 pm

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Child's Name *
Child's Name
Parent's Name *
Parent's Name
Parent's Cell Phone
Parent's Cell Phone
Address
Address
Which grade are they going into for Fall 2018?
Child's Date of Birth
Child's Date of Birth
If you would like to purchase a VBS T-shirt for your child, please indicate here. Cost: $10.00 paid the first night of VBS.
If you would like to purchase a VBS CD, please indicate here. Cost is $5.00, paid the first night of VBS. If you purchase a T-shirt and CD your total cost will be discounted to $13.00.