Vacation Bible School Registration June 28th - July 1st | 6:00pm to 8:15pm
Sullivan Church of the Nazarene | 1050 N. Main Street sullivan.nazarene@outlook.com Text (833) 509-7088 for details
Parent/Guardian Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Number
*
Format: (000) 000-0000.
How many children will be attending from your family?
*
ex: 1, 2, 3, 4, etc.
Participant Information
Complete fields below for each child attending
Child #1
*
First Name
Last Name
Age
*
Grade
*
PreK, 1st, 2nd, etc
T-Shirt Size
*
Child #2
First Name
Last Name
Age
Grade
PreK, 1st, 2nd, etc
T-Shirt Size
Child #3
First Name
Last Name
Age
Grade
PreK, 1st, 2nd, etc
T-Shirt Size
Child #4
First Name
Last Name
Age
Grade
PreK, 1st, 2nd, etc
T-Shirt Size
Do any of your child have any allergies or medical conditions we should be aware of? If yes, please describe.
Would you like to receive additional information about upcoming neighborhood events or dinners either by email or mail?
Yes
No
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