VBS 2017 • Intrepid Christian Church

Vacation Bible School July 18-21, 2017

Please complete this registration form and submit your payment via the link on the registration completion page.
Registration costs: $25.00 for the first child, $15 for each additional sibling.

Parent/Guardian Information:

Last Name *

First Name *

Email Address *

Phone Number *

Home Address *

Home City *

Home Zip Code *

Mailing Address (if different from above)

Emergency Contact (in the event you cannot be reached)

Name/Relationship/Contact Number *

Child's Information

Child's Name *

Gender *

Age/Grade (entering Fall of 2017) *

Allergies and/or Medical Conditions (if none, type 'none') *

Will you also be registering any siblings? *

If you answered no please scroll down, and click 'Submit.'
If you answered yes please enter the information for each additional sibling.

Additional siblings

Name:

Gender:

Age/Grade (entering Fall of 2017)

Allergies and/or Medical Conditions (if none type 'none')

Name:

Gender:

Age/Grade (entering Fall of 2017)

Allergies and/or Medical Conditions (if none type 'none')

Name:

Gender:

Age/Grade (entering in Fall 2017)

Allergies and/or Medical Conditions