Shipwrecked Vacation Bible School: Rescued by Jesus
(Downloadable Form)

Child Name
Email
Parent or Guardian Name
Address
Home Phone
Work Phone
Cell Phone
Date of Birth
Age
Last school grade completed
Home Church
Allergies/medical or other concerns
Emergency Contact Name
Phone Number
Who will pick up the child each day
Submit **
** This information is sent through email, a format that does not guarantee confidentiallity.  If this is a concern visit the church office to fill out a registration form in person.  Or download and fill it out from and bring it by the church office.**