Vacation Bible School Registration Form

To register for Calvary's 2007 VBS Program, July 15, 19, please complete the information below and click the "SUBMIT" button at the bottom of the form.  if you provide an e-mail address you will be sent a message acknowledging receipt of your form.

Child's Name:

Parent/Guardian Name:

Address:

E-Mail Address:

Phone Numbers:

    Home:     Cell:     Work:

Age Information:

    Date of Birth:      Age:

    Last school grade completed:

Home Church:

Allergies/Medical Information/Other:

Emergency Contacts:

    Name 1:     Phone1:

    Name 2:     Phone2:

Dismissal Information:
Name(s) of persons who may pick up this child from VBS each day:

Other Information (church use only):

Treasure Group:

Are parents helping with VBS?   (if yes,) Where?