Vacation Bible School (VBS) Child Registration
WEST BRIGHTON WEEK 1 - JULY 12, 13, & 14
Today's Date
-
Month
-
Day
Year
Date
Parent's Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone
*
Email
example@example.com
Emergency Contact & Ph #
*
Child - First Name
Last Name
Age
Gender
Child - First Name
Last Name
Age
Gender
Child - First Name
Last Name
Age
Gender
Child - First Name
Last Name
Age
Gender
Child - First Name
Last Name
Age
Gender
Church that your family attends:
If you are currently not attending a local church, would you like us to connect you to one in your community?
Yes
No
Which week and location are you registering for
*
July 11th-14th, NYCHA West Brighton
July 25th- 28th, NYCHA Stapleton
August 1st-4th, NYCHA Mariners Harbor
August 8th-11th, New Hope Community Church
August 15th-18th, NYCHA Todt Hill
August 22nd-25th, Park Hill
I give permission for my child / children to engage in physical recreation, to get wet and to have their pictures /videos taken during UH VBS)
*
Yes
No
Did not indicate
Please advise if your child/children have any allergies.
*
Thank you for Signing up your Child/Children for Summer Camp - Vacation Bible School (VBS)!!
Blessings!
Submit
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