Summer VBS Registration Camping Out: “Getting S’mores of Jesus” Dates: Monday June 19 – Friday June 23 :00 p.m. – 8:00 p.m. Ages: Kindergarten – 5th Grade Please provide us with the following information: Child’s Information Child’s First Name Child’s Last Name Child’s Age Please select one of the following grade levels you child is entering into SelectionsKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade Parent or legal guardian contact information First Name Last Name Address City State Zip Code Home Phone Cell Phone Emergency Contact Number Secondary Contact Number E-mail Addition Information Does your child have any special needs or disabilities that we need to be aware of? Does your child haven any food allergies that we need to be aware of? Do you have any concerns that you would like us to be aware of? Person(s) authorized to take child from premises? How did you hear about this event? Would you like to be notified of upcoming children events? yes no Submitting form will bring you back to our home page. Thank you for registering your child for Grace Life Vacation Bible School.
