2018 VBS Registration
2018 VBS Registration
Child's Name (1 child per form)  * 
Date of Birth  * 
Age - Ages 4 yrs thru 5th Grade (completed)  * 
Grade just completed  * 
Home Phone (if cell # is not available)
Your Email Address  * 
Home Address & city name * 
Dad's Name
Dad's Cell #
Mom's Name
Mom's Cell #
Other local emergency contact name
Other local emergency contact cell #
Please list any allergies
If you attend church regularly, where do you attend?
PHOTOGRAPHY: As the parent or legal guardian of this child, I give permission for my child's photograph to be taken while at the MaconFBC VBS.
It is understood that the photo may appear in a slide show at the closing program or in advertising of future children's events at MaconFBC. Signature of parent....
Please type in the box to the right »  * 
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