New Joy Church VBS Registration 2022
Please complete ONE FORM PER CHILD
June 26 - 30
6:30pm - 9:00pm
35 New Joy Drive, Ephrata
717-733-2864
Contact us at
office@findnewjoy.org
Child's Name
*
First Name
Last Name
Gender
*
Age (minimum 3 years by June 26)
*
Date of Birth
*
-
Month
-
Day
Year
Date
Last School Grade Completed (up to 5th grade)
*
Enter "0" if not in school yet
Name of Parent(s)
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Home Church (if applicable)
Allergies or Other Medical Conditions (if none, type "none")
*
Emergency Contact Name (if other than parent)
Emergency Contact Phone Number (if other than parent)
Please enter a valid phone number.
Relationship to Child
Submit
Should be Empty: