Grove Vacation Bible School Student Registration

2009 Vacation Bible School: Standing on the Promises

Dates: June 29 - July 2 Time: 6:00pm - 8:30pm

VBS Student Registration

(fields marked * are required)

Contact Information

* Name:
* Address:
* Zip Code
	,
Home Phone:
Cell Phone:
Email Address:

Attendee Information

* Child 1:

	Medical Conditions (allergies, asthma, etc)

Child 2:

	Medical Conditions (allergies, asthma, etc)

Child 3:

	Medical Conditions (allergies, asthma, etc)

Child 4:

	Medical Conditions (allergies, asthma, etc)

Emergency Contact Information

* Contact Name:
* Cell Phone:
Relationship:
Other Phone: (optional)

Home Church Information (optional)

Church Name:
City:
State:

Note: Parent or parent designated adult must remain on site for students ages 5 and under. For more information contact Sis. Irvine Lee at (757) 686-8029 or send email to pastoralvolunteer2@grovebaptistchurch.com.

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