Vacation Bible School Registration

MAIL IN OPTION:

If you prefer to register on paper, please download the 2010 Registration Form. Then please print, complete, sign and mail to Broadus.

2010 VBS Registration Form

PLEASE REGISTER THE FOLLOWING CHILDREN FOR VACATION BIBLE SCHOOL 2010

* First Child's Name

* Age

Second Child's Name

Age

Third Child's Name

Age

Fourth Child's Name

Age

Do you have any special requests as we assign your child(ren) to a family (i.e., keeping siblings together, assigning your child to the same group as a friend, etc.)?

* Are there any allergies or other medical conditions we should know?

* Number of family members participating in VBS:

Your Contact Information

* Parent/Guardian Name

* Address1

Address2

* City

* State

* Zip

* Email

* Phone

Cell

Emergency Contact Information

* Emergency Contact Name

* Relationship to Child

* Emergency Contact Phone

Emergency Contact Cell

Confirmation (Required)

Check this box to confirm you are the parent or guardian listed above. This will serve as your digital signature for this registration.

I confirm that I am the parent/guardian of the above listed child(ren) *

Script by Dagon Design

Broadus Memorial Baptist Church

Vacation Bible School Registration

PLEASE REGISTER THE FOLLOWING CHILDREN FOR VACATION BIBLE SCHOOL 2010

Your Contact Information

Emergency Contact Information

Confirmation (Required)