Vacation Bible School Registration

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We are excited to have you join us during Vacation Bible School this year! There is NO REGISTRATION FEE, so please fill out the form below and we will see you on June 26th at 9:00 AM!

Dates: June 26-30

Times: 9:00 - 11:45 am

Where: Palmyra Moravian Church

1921 Cinnaminson Ave.

Cinnaminson, NJ

Email *

Child's Name? (First Last) *

Parent's Name? (First Last) *

Parent Home Phone Number? *

Parent's Cell Number? *

Child's Age? *

What grade is your child going into this school year? *

Pre-K

Kindergarden

First Grade

Second Grade

Third Grade

Fourth Grade

Fifth Grade

I am to old for VBS, but am interested in helping out!

Name of your Home Church? *

Emergency Contact Name *

Emergency Contact Phone Number *

Who is permitted to pick up your child(ren) if you are unable? *

Are their any allergies or medical concerns we need to be aware of for your child? *

Yes

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