St Peterís by The Sea Presbyterian Church

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St. Peter's by the Sea Presbyterian Church

Vacation Bible School - Child Registration

July 15 - 19, 2019   9:00 am - 12:30 pm

* Denotes a required field to fill in
Child's First Name*
Child's Last Name*
Address*
Address Line 1 
Address Line 2 
City     State     Zip 
Birthdate*  
Grade STARTING THIS FALL 2019*
T-shirt size
Parent/Guardian First Name*
Parent/Guardian Last Name*
Phone (including area code)*
Email*
Verify Email*
Emergency Contact Name*
Relationship to child*
Phone #1*
Phone #2
Person responsible for picking up child*
Their phone number*
Their relationship to Child
Alternate person responsible for picking up child:
Their phone number:
Allergies or Special Needs. Enter None or N/A if this does not apply.*
Special friend your child would like to be with
Is this your family's first time attending VBS at St. Peter's?*
Yes
No
How did you hear about VBS at St. Peter's?*
If you have one, what is your home faith community?*

RELEASE FORM REQUIRED:


Acceptance:* 
Full Name:*