Are you ready to explore Egypt?

Child’s Name:*

Parent/Guardian Name:*

Address:

Home telephone:*

Cell phone:

Child’s age:*

Last school grade completed:*

Home e-mail address:

Home congregation (if any):

Where did you hear about our VBS program:

 

Emergency Contact Information

Name:*

Telephone:*

Relationship to child:*

Please list any allergies (including food allergies) the VBS staff should be aware of:*

(Please put "None" if no allergies)

 

Person responsible for picking up this child at the end of each VBS day
Required if different from Parent/Guardian above

Name:

Telephone number:

Signature of parent/guardian will be needed on the first day, so please come a few minutes early.

* Required to reserve a spot for your adventurer