Institution Name
CHILD INFORMATION
EMERGENCY CONTACTSPlease list the first and last names and phone numbers off ALL adults who are allowed to pick up this child. The child will only be released to these people.
Medical Information
By submitting this form, I ackowledge I have read and understand the above information.
Click here for our onling giving portal. You can click on the dropdown menu and select "Vacation Bible School". There is a fee of $30 per child with a family max of $100.