Sunday School Emergency Medical Form

VACATION BIBLE SCHOOL 2010

VBS 2010 ~Monday,June 21 through Friday, June 25. Time: 6:30-8:30 p.m. The theme was Galactic Blast!

You Can Use The Registration Form Below and Send it Directly to the Church.

Alternatively, you can print it out and bring it to the office

Childs Name: *
Age: *
Childs Name:
Age:
Childs Name:
Age:
Childs Name:
Age:
Street Address/City: *
Home Phone: *
Cell Phone:
E-mail Address: *
In case of Emergency, Contact: *
at phone number: *
Persons Responsible for Picking up Child(ren) from V.B.S. Mother:
Father:
Other:
Please List Childs Name and Allergy or Medical Conditon:
Name of Special Friend your Child(ren) might like to be with: (if reg. by June 11th)
Galactic Group (For Church Use Only)


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