Monday July 11th – Friday July 15th… Dinner Served: 5pm – 6pm… Activities: 6pm – 8pm…

VBS 2022 Registration Form

Child's Name *

Child's Gender *

Male

Female

Child's Age

Child's Birth Date

Last School Grade Completed

Name of Parents *

Street Address *

City *

State *

Zip Code *

Home Telephone Number

Parent's / Caregiver's Cell Phone Number *

Home Email Address *

Home Church

Allergies, medical conditions, or special needs:

In case of an emergency, contact: *

Emergency Contact's Phone Number *

Relationship to the child *

Thank you for registering your child for FMBC's 2022 VBS. We look forward to seeing y'all on Monday July 11th.

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