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The Road - Zoomerang Vacation Bible School
Registration for VBS June 14-15, 21-23, 6:30-8pm, Clever City Park.
Sorry, but you will need to complete this for each child. 417-849-2515 for more information. VBS activities are for those 4 years old up through going into 6th grade.
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Email
*
Your email
Child First Name
*
Your answer
Last Name
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Your answer
Grade this fall (preK at bottom)
Choose
Kindergarten
1st
2nd
3rd
4th
5th
6th
PreK (4 years old or older)
Likely to attend on days :
*
Wednesday, June 14
Thursday, June 15
Wednesday, June 21
Thursday, June 22
Friday, June 23
Required
Birthdate
*
MM
/
DD
/
YYYY
Parent first name
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Your answer
Parent Last Name
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Your answer
Cell Phone
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Your answer
Address
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Your answer
City
Your answer
State Abbreviation
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Zip Code
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Allergies or Medical Conditions
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Emergency Contact Name
*
Your answer
Emergency Cell #
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Your answer
Other People Allowed to pick up the child
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Your answer
I've downloaded and read the release form.
*
Yes
No
Full Release form
2023 The Road VBS Release Form
Signature after viewing Release form
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Your answer
A copy of your responses will be emailed to the address you provided.
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