VBS Registration for July 2017

Your Child's Info

Name

Gender

Male Female

Birthday

*For the birthday field you can choose using the pop-up calendar or just type the date using DD/MM/YYYY formatting.

Grade Entering in the Fall of 2017

Pre-K (potty trained 3 or 4 year old) Kindergarten 1st or 2nd 3rd or 4th 5th or 6th 7th or 8th 9th - 12th

Parents / Guardians

Your Name

Address

Home Phone

Cell Phone

Work Phone

This address will receive a confirmation email

Emergency Contact Info

Name

Relationship to Child

Phone

Health Info

Food Allergies

Yes No

List

Medical Concerns

Yes No

Explain

Pick Up

Who who will be picking up your child?

Who is NOT permitted to pick up your child?

Lastly...

What's the name of your home church?

How did you learn about VBS at FBCP?

May we take and share photos of your child?

Yes No

Description

Monday, July 17th - Friday, July 21st 6:30-9:00 PM

Please take a moment and fill out this form. When finished, click submit.

You will need to fill out this page for each of your children.

If you have any questions, feel free to email the VBS Team at vbs@fbcpatchogue.com!

The First Baptist Church of Patchogue
482 North Ocean Avenue
Patchogue, NY 11772
631-289-0230
fbcpatchogue.com

Mon-Fri Office Hours
8:30 am - 3:30 pm

Sunday
8:15 am - Morning Worship
9:30 am - Bagels & Coffee
9:45 am - Sunday School
11:00 am - Morning Worship
6:00 pm - Evening Service

VBS Registration for July 2017

Description

Please Fix the Following