Vacation Bible School Registration
Galactic Blast

July 26-20, 2010
9:00am-12noon

Name(s):

Parent/Guardian Name(s):  

Age(s):  Birthday(s):  Grade(s) in the Fall:

Address:

Home Phone:   Cell Phone:  Email:

Shirt size(s):

Emergency Contacts:
Name:  phone:
Name:  phone:

List names of persons who may pick up your child from VBS each day: