2023 Daytime VBS Registration

Kettering Baptist Church Legacy Center

Pastor Bucas Sterling III
2023 Vacation Bible School Daytime Registration Form

"Twist & Turns, Following Jesus Changes the Game"

Daytime VBS will be from 7:30am to 5:30pm Tuesday, June 20th through Friday, June 23rd and Monday, June 26th through Friday, June 30th for 1st through 8th grade. The cost is $180 for 1 child, $165 per child for 2 children, $150 per child for 3 or more. This cost includes daily field trips, lunch & snacks.
Adult Completing Registration:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*

Confirmation Email
Daytime Phone Number*
Cell Phone Number*
How did you hear about VBS?
Alternate Emergency Contact Information:
Alternate Emergency Person Contact *

First NameLast Name
Alternate Emergency Contact Phone Number*
How many children will you be enrolling for VBS?*

123
Enter Student(s) Information:
Name of Student 1 *

First NameLast Name
Age*
Choose your VBS week(s)*

Week #1 Tuesday, June 20th - Friday, June 23rdWeek #2 Monday, June 26th - Friday, June 30th
T-Shirt Size*

SmallMediumLarge
Grade (in Sept 2023)*
example enter 1 for 1st grade
Medical Information (Please list any medical information/condition or food allergies we should be aware of)
weeks
Name of Student 2

First NameLast Name
Age
Choose your VBS week(s)*

Week #1 Tuesday, June 20th - Friday, June 23rdWeek #2 Monday, June 26th - Friday, June 30th
T-Shirt Size*

SmallMediumLarge
Grade (in Sept 2023)
example enter 1 for 1st grade
Medical Information (Please list any medical information/condition or food allergies we should be aware of)
weeks
Name of Student 3

First NameLast Name
Age
Choose your VBS week(s)*

Week #1 Tuesday, June 20th - Friday, June 23rdWeek #2 Monday, June 26th - Friday, June 30th
T-Shirt Size*

SmallMediumLarge
Grade (in Sept 2023)
example enter 1 for 1st grade
Medical Information (Please list any medical information/condition or food allergies we should be aware of)
weeks
Pickup Permission:
I First Name* Last Name* grant permission in my absence for the person(s) listed below to retrieve the above name child(ren) from the Kettering Baptist Church Daytime VBS.
Pick Up Person #1
Name*

First NameLast Name
Phone Number
Alt Phone Number
Pick Up Person #2
Name

First NameLast Name
Phone Number
Alt Phone Number
Signature*

Clear
Date*

MonthDayYear
Date
Number1
Number2
Number3-6
Totweeks
Quanity
Total
Total cost for child(ren) attending VBS 2023 *

prevnext( X )
USDDescription
The cost per week is:
$180 for one child
$165 per child for two children
$150 per child for three or more children
Point of Contact:

Pastor Andre Williams

office: 301-627-9500

Email: andre.williams@ketteringministries.org

or

Minister Ryan Richardson

office: 301-627-9500

Email: rrichardson@ketteringministries.org
Should be Empty:

Kettering Baptist Church Legacy Center