Jesus Said "Follow Me"

Class: ______
Teacher: _________

V.B.S. Registration Form

Name: __________________________________

Age: ________ Grade Completed: _______ Birthday: ______

Parent's Names:
Mother: _______________________________
Father: ________________________________

Address: _____________________________

City: ______________ State: __________ Zip: _____

Home Phone: __________ Alternative Phone: __________

Emergency contact person: ___________________________

Family Doctor: ___________________________ Phone Number: ___________

Allergies or other Medical Problems: ______________________________________
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Siblings (Names and Ages): ______________________________________________
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Church Affiliation: ___________________________

Baptized: ____Yes ____No

Brought by: _______________________________________________