Preschool VBS 2024
Free to 3 Year olds (potty trained) thru Kindergarten graduates!
May 28th-31st 9 am - 11 am
Eaton Communtiy Church, 1561 Benjamin Dr
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone
*
-
Area Code
Phone Number
Alternate Phone
-
Area Code
Phone Number
Email Address:
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Physician Name
*
Physician Phone Number
*
-
Area Code
Phone Number
Relation to Child(ren)
*
Father
Mother
Guardian
Other
May we take pictures of your child(ren), to be used for slide show on Friday and church related marketing throughout year, no names will be used.
*
Yes
No
Is there anyone you child(ren) should NOT be released to?
*
If not, just type no in the above box. Thank you!
Child Information
Name of child
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Biological Gender
*
Male
Female
Age Group: (Grade most recently completed)
*
3 year old (potty trained)
4 year old
5 year old
6 year old (kindergarten graduate option also)
Does your child have any food allergies or medication concerns we should know about?
*
Register another child?
*
Yes
No
Submit
Should be Empty: