VBS 2016 Submerged Registration

VBS 2016 Submerged Registration

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VBS 2017: Galactic Starveyors Registration
Event Timing: June19th-23rd, 2017 Lite Meal @ 5:30 pm VBS From 6:00 pm - 8:30 pm
Event Address: 1003 West Carolina Ave. Hartsville SC 29550
Contact us at (843) 332-6221 or jonathan@westhartsville.org
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Child's Name *
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Parent/Guardian Name *
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Address *
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Mailing Address (if different from above) *
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Contact Info (Phone Numbers: Home, Work, Cell, and Email) *
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Age Information:  Birth Date and Last Grade Completed *
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Medical Information:  Medical or any other information that we need to know. *
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Dietary restrictions *
Emergency Contact #1: Name and Phone Number *
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Emergency Contact #2: Name and Phone Number *
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Who may pick up your child at the end of each night? *
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Does your child attend church regularly?  If so where? *
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If your child is visiting our church, who are they a guest of? *
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May we have permission to photograph your child? *
May we have permission to use your child's photograph for the purpose of promotion? *
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