Guardian’s Name *

Child’s Name

Grade Going intoPre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th grade

Child’s Age

Phone Number of contact during this VBS

Child‘s Address

City, State Zipcode

Added Information (allergies, medicine, special needs) *

My child been saved/baptized.

We attend a local church.

What Church?

E-Mail

5 + 3 = ?Please prove that you are human by solving the equation *