Wonder Junction VBS Registration Form
July 28-August 1, 9AM-11:30AM, Immanuel Baptist Church
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Child's Name
What grade did this child just complete?
*
Who can pick up your child?
*
Is there anything we need to know to properly care for your child? (food allergies, medical conditions, etc...)
Is there another contact number we can use in the event of an emergency?
By signing, I give permission for my child to attend VBS at Immanuel Baptist Church.
*
Submit
Should be Empty: