VBS REGISTRATION


Child's name:
Street Address:
PO Box:
City:
State:
Date of Birth:
Grade completed:
Home Phone:
Emergency phone:
Is child enrolled in a Sunday school?
Is Child an active member of a church?
Mother's name:
Is mother an active member of a church?
If so, where:
Father's name:
Is father an active member of a church?
If so, where: