White Rock Fellowship VBS Registration Form
Event Dates: June 17 - 20, 2019
Event Time: 7:00-8:30 PM
Event Address: 21070 Schulley Rd, Noblesville, IN 46062
Email *
Legal Guardian's First Name *
Legal Guardian's Last Name *
Legal Guardian's Phone Number *
Emergency Contact's First Name (not legal guardian)
Emergency Contact's Last Name (not legal guardian)
Emergency Contact's Phone Number (not legal guardian)
Child's/Children's Primary Home Street Address
Child's/Children's Primary Home City
Child's/Children's Primary Home State
Child's/Children's Primary Home Zip Code
1) Child's First Name
1) Child's Last Name
1) Child's Gender
Clear selection
1) Child's Age/Grade Just Completed
Clear selection
1) T-shirt Size ( T-shirt Sizes only guaranteed to those who register by May 31, 2019 at 12:00 PM)
Clear selection
1) Please specify any special needs we should be aware of (IE: Allergies, Learning Disability, ETC.).
2) Child's First Name
2) Child's Last Name
2) Child's Gender
Clear selection
2) Child's Age/Grade Just Completed
Clear selection
2) T-shirt Size ( T-shirt Sizes only guaranteed to those who register by May 31, 2019 at 12:00 PM)
Clear selection
2) Please specify any special needs we should be aware of (IE: Allergies, Learning Disability, ETC.).
3) Child's First Name
3) Child's Last Name
3) Child's Gender
Clear selection
3) Child's Age/Grade Just Completed
Clear selection
3) T-shirt Size ( T-shirt Sizes only guaranteed to those who register by May 31, 2019 at 12:00 PM)
Clear selection
3) Please specify any special needs we should be aware of (IE: Allergies, Learning Disability, ETC.).
4) Child's First Name
4) Child's Last Name
4) Child's Gender
Clear selection
4) T-shirt Size ( T-shirt Sizes only guaranteed to those who register by May 31, 2019 at 12:00 PM)
Clear selection
4) Child's Age/Grade Just Completed
Clear selection
4) Please specify any special needs we should be aware of (IE: Allergies, Learning Disability, ETC.).
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