VBS 2011 ~ TBD
June 20-23, 6:00pm-8:30pm
#1 Child Name
Buddy
Birthdate
Male or Female
Please Select
Male
Female
Grade in Fall
#2 Child Name
Buddy
Birthdate
Male or Female
Please Select
Male
Female
Grade in Fall
#3 Child Name
Buddy
Birthdate
Male or Female
Please Select
Male
Female
Grade in Fall
Address
City, ST, Zip Code
Attends Church
Please Select
yes
no
Where
Special Instructions / Allergies
Parent/Guardian
Email Address
Home Phone
Cell Phone
Emergency Contact Person
How did you hear about our VBS?
Please Select
Website
Door Hanger
Magazine
Newspaper
Yard Sign
Banner
Other
If you listed Other above, please let us know how you heard about our VBS.
Emergency Phone #
T-SHIRTS ARE AVAILABLE IN THE CHURCH LOBBY AS LONG AS SUPPLIES LAST $10 EACH
As Parent/guardian of the above named children, I give permission for them to attend VBS sponsored by Mansfield Bible Church. In the event of any accident, illness, or other problem which might occur, I will not hold Mansfield Bible Church or any of the church's volunteers liable. I consent to my child or me being photographed or videoed and for those pictures/videos to be used on MBC website and during any MBC events.
Parent Signature
Date Signed
By signing, you consent to the above statement.
Submit
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