VBS Registration Form

	INFORMATION
Ages: 3 to 6^th Grade.	VBS Celebration: Thursday, 24 June @ 12:30pm.	Point of Contact: Harper Lewis 722-2567.
EXCELLENT EXODUS ADVENTURE: Time travel though 400 years - from the Sea to the Stars Hellooo Parents! Mark your calendars now for an exciting week - Monday, June 21th through Thursday, June 24th from 9:30 a.m. to 12:30 p.m. Our VBS is open to children age 3 through sixth grade. There will be a special presentation on Thursday, June 24th at 12:30 p.m. We will create a wonderful week where children will learn, laugh, love, and pray. We will listen to great stories about Jesus, make cool crafts, sing fun songs, play zany games and make tons of new friends.
* Required information. + Optional information ‡ The other field is optional if this field is filled in.

Child's Name* [Note: All names must have a first and last on this form]

Date of Birth* [mm/dd/yy] Age* [3 - 11] Last grade attended* [None, PK, K, 1 - 5]

Home Church+ Likes to be with Special Friend+

(Our Vacation Bible School is designed for children to be placed in small similarly-aged groups, so we can usually put two friends together but not a whole group - VBS is a great time to make new friends!)

Address*

City* State* Zip*

Primary Phone* Alt Phone+ E-mail+

Mother/Guardian‡ Work Phone‡

Father/Guardian‡ Work Phone‡

Emergency Contact* Phone*

List all others to whom the child may be released+

List allergies or other medical conditions+

Is there anything else that we should know+

Please Standby

Vacation Bible School Registration

Monday, 21 June- Thursday, 24 June, 2010
9:30 A.M. to 12:30 P.M.

Open to all Christian Denominations!

INFORMATION

EXCELLENT EXODUS ADVENTURE:
Time travel though 400 years - from the Sea to the Stars