Perfecting Ministries Vacation Bible School Registration
If need to register more than 5 children, please submit a new form.
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Childs Name #1
First Name
Last Name
Age
Date of Birth
School Grade in the Fall
Childs Name #2
First Name
Last Name
Age
Date of Birth
School Grade in the Fall
Childs Name #3
First Name
Last Name
Age
Date of Birth
School Grade in the Fall
Childs Name #4
First Name
Last Name
Age
Date of Birth
School Grade in the Fall
Childs Name #5
First Name
Last Name
Age
Date of Birth
School Grade in the Fall
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
*
First Name
Last Name
Name of Person Bringing Child
First Name
Last Name
Allergies/Medical Information
*
How did you hear about our VBS?
*
Additional information we may need to know about your child.
Emergency Information
Person to Contact
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Submit Registration
Should be Empty: