VBS 2011 Registration

Written by on April 28, 2008
Categories: What: Here's What We Do

You can now register for our 2011 Vacation Bible School, Planet Zoom. Please complete the following form. If you wish, you may return to our Planet Zoom site by clicking on Planet Zoom Vacation Bible School.

Child's Name
Grade completed
Birthday
Age
Parents' names
Home Address:
City
State
Zip Code
Home Phone
Alternate Phone
Email
Confirm email
Emergency Contact Person
Relationship to Student
Their Home Phone
Alternate phone
Food Allergies?
List food allergies
Medical concerns?
List medical concerns:
Family Doctor
Doctor's Phone
Siblings attending VBS
Church affiliation
Church Membership
People who may pick up child
Transportation needed?
Days child will attend
VBS leaders have permission to photograph/film the minor(s) designated here in any manner or form for any lawful purpose associated with this VBS program
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