Vacation Bible School Registration Form

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Date and time: Monday-Friday, July 10-14, 2023, from 9 am-Noon every day (registration begins at 8:45 am)
Event Address: ChristLife Church, 200 E. Hamilton Street, Bunker Hill, IL 62014
Contact us at (618) 585-4544 or christlifebh@gmail.com

Ages 4 years through 6th grade

电子邮件地址 *

Child/ren's first and last name/s *

Age/s (with names) *

Grade entering this fall (please write in bottom if multiple children) *

Kindergarten

其他:

Address (with city, state, and zip) *

Parent(s)/Guardian *

Parent's email

Parent's phone *

Emergency contact phone other than above *

Name of pick-up person *

Phone number of Pick-up Person *

Do you currently have a home church? *

Yes

No, but looking for one

其他:

Allergies, food or otherwise? (if multiple children, please list their names next to allergies) *

Medical conditions to be aware of (if multiple children, please list their names next to conditions)

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