2019 VACATION BIBLE SCHOOL REGISTRATION

Children ages 4 through rising 5th graders (2019-20).

Registration fee $20.00 per child - maximum $50.00 per family - due July 17.

Cash or personal check made payable to: Eastbridge Presbyterian Church.

Name

First Name

Last Name

Age

Birthdate:

MM

DD

YYYY

Grade Entering:

Parent/Guardian's Name:

First Name

Last Name

Home Address:

Best Number to Reach You:

(###)

###

####

Best Email to Reach You:

Emergency Contact:

First Name

Last Name

Best Number for Emergency Contact:

(###)

###

####

Food Allergies/Medical:

Church Home:

Have you ever attended VBS at Eastbridge?

Check one:

YES

NO

T-shirt size

Enter a size 4T to Youth XL

Please submit a form for each child.

COME VISIT US: