UPCOMING EVENTS

Another Emergency Contact Number: *

Last Grade Completed: *

Child's Gender: *

Male

Female

Please list any additional comments that you feel we need to know about your child:

Medical or other information we need to know about your child (please include food allergies):

Emergency Contact Name: *

Another Emergency Contact Name: *

At our Vacation Bible School, kids will have fun and learn about Jesus! We will have a rotation of various activities and fun games to play, as well as bible study lessons and kids worship. We will serve a snack every day to all of our students. Everything is FREE!! Fill out the form below to register.

For more info, please contact our church office at (337) 278-2206.

Email: *

Address: *

Parents or Guardians Name: *

Child's Name: *

Who can pick up your child at the end of each day? Please list anyone who has permission to pick up your child: *

Emergency Contact Number: *

Do you attend church? If so, where: *

Child's Birthdate: *

Contact Number: *