First Baptist Church of Gaston
Wednesday, March 21, 2018

VBS Registration Form

Child's Name 
Male   Female
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