2019 VBS Registration
Event Timing: July 14-18
Event Address: 118 Main Street, Buies Creek, NC 27506
Contact us at (910)893-4280 or debbie@bcfbc.org
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Child's Name *
Child's Gender *
Child's age *
Date of Birth *
MM
/
DD
/
YYYY
Last School Grade Completed *
Name of Parent(s) *
Street Address *
City *
State *
ZIP *
Cell Phone *
Home Church
Email *
Allergies *
Medical Conditions *
In case of emergency contact: Name and Cell # *
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