VBS Registration

Crocodile Dock VBS
July 26 - 30, 2009, Sunday - Thursday, 6:30 - 9:00 p.m.

Age 4 through completion of Fifth Grade

* First Name

* Last Name

* Gender

* Address 1

* City

* State

* Zip

* Home Telephone

Parent's Cell Phone

* Email Address

* Date of Birth

* Age

* Grade Completed this Year

One friend you would like to have in your crew:

*Crew assignments will be done the week before VBS.
You will be notified by mail or email.

* Father's Name

* Mother's Name:

* In case of emergency, contact:

Home Church

* Did you attend VBS here before?

yes

* Allergies or other medical conditions:

* Parent: I give my persmission for my child/children to be photographed and videoed for church purposes during VBS.

Yes

Elementary (Kind. - Grade 5) T-Shirt Size:

Youth Medium

Youth Large

Adult Small

Adult Medium

Notes:

We will provide a CD of VBS songs (1 per family). We ask that those that regularly attend King Street Church pick theirs up at the VBS tables in the church lobbies. CDs will be mailed to those that do not regularly attend King Street Church.

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