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VBS Registration, July 21-25, 2008
This is the registration form for VBS at Lawrence Free Methodist Church
Parent/guardian name(s):
*
Street address:
*
City:
*
State:
*
Zip code:
*
Parent/guardian email address(es):
Phone number(s):
*
Child's first name:
*
Child's last name:
*
Child's birth date
*
month
January
February
March
April
May
June
July
August
September
October
November
December
day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Child's current age:
*
select...
4
5
6
7
8
9
10
11
12
Child's gender:
*
select...
Female
Male
Special information:
*
Please provide any special information your child's teacher(s) should know
One-on-one care:
*
Yes
No
Does your child require one-on-one care?
Food allergies:
Authorized adults:
List any other adults who are authorized to pick up your child.
