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Church Radiant VBS Registration
Please fill out this form and e-sign the waiver to confirm your registration at Church Radiant's Vacation Bible School. We cannot wait to see you!
If you have questions, please email us at
churchradiant525@gmail.com
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Email
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Your email
Child's Name (First and Last)
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Your answer
Grade entering, September 2019
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Kindergarten
1st
2nd
3rd
4th
5th
6th
Parent Name
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Your answer
Parent Phone Number
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Your answer
Address
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Your answer
Do you attend a local church? If so, which one?
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Your answer
Emergency Contact Name
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Your answer
Emergency Contact Phone Number
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Your answer
Allergies or medical needs we need to be aware of (please include food allergies)
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Your answer
Medical Insurance and Provider
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Your answer
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