First Baptist Church of Gaston
Sunday, December 17, 2017
THE CARING PLACE

VBS Registration Form

 
Child's Name 
 
Male   Female
 
 
 Age
 
Birthdate
 
Grade Just Completed
 
Parent or Guardian's Name
 
Home Telephone
 
Street Address
 
City, State, Zip
 
Alternate Mailing Address  
(If different for Street Address)
 
Email Address
 
Emergency Contact
(If other than Parent)
 
Emergency Phone
(Other than Parent)
 
Is your child allergic to anything?  Yes NO
 
If so, What is your child allergic to?
Please provide any other medical information we may need to know.
 
Church You Regularly Attend