2022 Vacation Bible School Registation

Parent/Guardian Name(s)

Address

This address will receive a confirmation email

Preferred Phone

Emergency Contact

Emergency Contact Phone Number

Relationship to child

Name and Contact of person responsible for pick-up from VBS (if not parent/guardian)

My child(ren) may be photographed/included in video for use in church presentation or church promotional materials (including social media)

YES NO

Fill out information for each child you are registering.

Child's name

Date of Birth

Grade completed spring 2022

Gender

Special needs/allergies

Child 2

Child's name

Date of birth

Grade completed 2022

Gender

Special Needs/Allergies

Child 3

Child's Name

Date of Birth

Grade completed spring 2022

Gender

Special Needs/Allergies

Child 4

Child's name

Date of Birth

Grade completed spring 2022

Gender

Special Needs/Allergies

Pay and Submit

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Jerusalem Marketplace, July 11 - 15, 2022, 9 a.m. to noon, for children in preschool (3 1/2 years) through Grade 5. Cost is $25 for one child; maximum family rate, $50. Please enter information for each child. Be sure to click "Submit." If this is the first time your child is registered for Vacation Bible School, your registration is FREE!

2022 Vacation Bible School Registation

Description

Please Fix the Following