Stevens Street Baptist Church VBS 2013

VBS Registration

Child's Name *

Parent/Guardian Name *

Street Address *

Zip Code *

Home or Cell Phone Number *

Cell or Work Phone Number

Child's Date of Birth *

Does your child have any medical information we need to know? Example: Allergies *

Please list 2 emergency contacts for your child. (Name & Phone #) *

May we have permission to photograph your child to use for future promotion? *

Yes

Where do you attend church?

Where did you hear about our VBS?

Church Announcement

Family, Friend, or Co-worker

Website

Welcome