VBS 2019

July 22-26 6pm-8:30pm

PowerUp_Background_05.jpg

Fill out the Registration Form Below

 

Child's Name *
Child's Name
Parent/Guardian Name *
Parent/Guardian Name
Address
Address
Phone *
Phone
Child's Birth Date
Child's Birth Date
Grade Just Completed *
Check the box next to your child's age or last grade completed
May we have permission to photograph your child? *
May we have permission to use your child's photograph for the purpose of promotion? *