2017 Vacation Bible School Registration

Child's Name

Parent/Guardian's Name

Parent/Guardian's Cell Phone

Alternate Phone

Address

This address will receive a confirmation email

Emergency Contact

EC Phone

Birthday

Age/Completed Grade

Please list all Medical Conditions or Allergies

Who may pick your child up each day?

LMBC takes promotional photos and video and during VBS. Also, photos are sometimes used by classes and for craft purposes. May we have permission to photograph/video your child?

Yes No

Description

June 5-9th 8:15-11:30 am

We are looking forward to having your child at VBS at Longview Missionary Baptist Church. Please fill out this form and click submit.

2017 Vacation Bible School Registration

Description

Please Fix the Following