Vacation Bible
School '10
June 14-18
8:45 am - 12 Noon
Commencement
Sunday Evening
June 20th
6 pm
COME AND JOIN US FOR SOME HIGH SEAS FUN!
Registration Form
Child’s name: ______________________________________________________________________
Child’s age: _______ Date of birth: ______________
Last school grade completed: _________
Name of parent(s): _________________________________________________________________
Street address: ____________________________________________________________________
City: _______________________________________ State: ________ ZIP: __________________
Home telephone: (_______) __________________________________________________________
Parent/caregiver’s cell phone: ________________________________________________________
Home e-mail address: ______________________________________________________________
In case of emergency, contact: _______________________________________________________
Relationship to child: _______________________________________________________________
Allergies or other medical conditions: ___________________________________________
Home church: _____________________________________________________________________
Crew number or name
(for church use only): _______________________________________________(One Per Child)