VBS Registration Form

Please fill out the form below (one per child) to register your child for SJPC's Vacation Bible School, "HERO Headquarters: Where Kids Join Forces With God", coming June 13-17, 2010 from 5:30 - 8:30 PM.

Child's Name Required

Birth Date Required

Age Required

Grade Completed Required

Name of Siblings Attending VBS

Parent's Name Required

Address Required

Street Address

City

State

Zip Code

Phone Number Required

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St. Johns Presbyterian Church

VBS Registration Form

Child's Name Required

Birth Date Required

Age Required

Grade Completed Required

Name of Siblings Attending VBS

Parent's Name Required

Address Required

Phone Number Required

Page or Cell Phone

Email Address

Church Home

Emergency Contact Name Required

Relationship to Child Required

Emergency Contact Phone Required

Allergy/Health Conditions

Is there a special friend your child would like to be with?