Vacation Bible School Registration Form
The Harbor Church of Genesee County
Childs Name:
First Name
Last Name
Childs Age Group:
Please Select
6 - 8
9 - 12
13 - 15
Current Grade:
1st Grade
2nd Grade
3rd Grade
4th Grade
4th Grade
5th Grade
Other
Does the child have any allergies?
Yes
No
Please explain the allergy so proper arrangements can be made by our staff.
Has the child attended VBS with us before?
Yes
No
Emergency Contact Information
Please enter the name of parent or guardian who should be contacted in case of an emergency.
Relationship:
Sibling
Parent
Child
Friend
Other
Full Name
First Name
Last Name
E-mail Address
example@example.com
Contact Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Any questions or concern:
Submit
Should be Empty: