Vacation Bible School Registration

Register here for Vacation Bible School! Our registration process is secure and completely safe. The cost for this year's VBS is $15.00 per child with a maximum of $40.00 per family if registered by June 3, 2008. After June 3, 2008, it is $20.00 per child if space is available.

Each family will receive one free music CD upon registration. You may pick it up in the church office.

Amount (ex. 15.00)	Fund Vacation Bible School
Parent (Guardian) Name(s)	Home Phone
Work Phone	Cell Phone
E-Mail Address	Local Emergency Contact Name
Local Emergency Contact Phone	Member? (Y/N)

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Child #1 Name	Child #2 Name
Child #1 Birthdate	Child #2 Birthdate
Child #1 Grade in Sept. 2008	Child #2 Grade in Sept. 2008
Child #3 Name	Child #4 Name
Child #3 Birthdate	Child #4 Birthdate
Child #3 Grade in Sept. 2008	Child #4 Grade in Sept. 2008

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List any food allergies we should know about:

Persons (other than parent/guardian listed above) who have permission to pick up my child:

Is there anyone not legally allowed to pick up your child? If yes, please provide name:

Do we have permission to use your child's picture in future brochures, website ads, and other church publications? Please indicate Yes or No.

Did you sign up to volunteer for Vacation Bible School - all week or part of the week? (Y/N)

Merchant Account