VACATION BIBLE SCHOOL 2010 - Printable Registration Form
July 19-23 (age 4 to completion of grade 5)
One form for each child - Please print

Name: _____________________________________________

Address: ______________________________________________

______________________________________________

Postal Code: _____________________________________

Phone Number: ____________________________

Date of Birth: ______________________________

Home Email Address (optional): __________________________________________________________

Last Grade Completed in School: _________________________________________________________

Home Church: ______________________________________________________________________

Medical, Allergy, Or Other Information We Need to Know: ______________________________________

________________________________________________________________________________

________________________________________________________________________________

In the event of an emergency, whom do we call?

Name: _________________________________ Phone:_____________________________________

Name: _________________________________ Phone:_____________________________________

Who will pick up your child at the end of each day?

Name: _________________________________ Phone:_____________________________________

Click here to print form.
Please return completed form by July 11 to the Geary Baptist Church.