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VBS 2024 Registration Form
June 2-6, 2024; 6:30-8:30 PM
For Ages 3-11
Northridge Baptist Church
1300 E. Cook Road
Fort Wayne, IN 46825
260-489-6633
www.nridgebaptist.com
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Breaker Rock Beach VBS 2024
Parent/Guardian Name
*
Your answer
Address
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Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Child(ren)'s Name, Age, and Birthdate
*
Your answer
Food Allergies
*
Dairy
Gluten
Nuts/Peanuts
None
Other:
Required
May we have permission to photograph/video your child(ren)?
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Yes
No
May we have permission to use your child's photograph/video footage in church publications? (We make a video that is shared on our YouTube page and at our church)
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Yes
No
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