Parkside's Vacation Bible School
July 16-July 18 -  Register each three year old -  6th grader SEPARATELY.
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Next Steps Class
Child's First Name *
Last Name *
Home Address *
Zip Code *
City *
Date of Birth *
MM/DD/YYYY
Home Phone *
(XXX) XXX-XXXX
Cell Phone
(XXX) XXX-XXXX
Email Address *
Parents Names *
Parent(s) Work Phone
Emergency Contact Information *
Please provide name & number
Allergies or Medical Conditions we should be aware of
Age/ School Grade Completed *
Do you grant permission for Parkside Church of the Nazarene to use pictures of your child on its website and social media for informational or promotional purposes. *
Are there any days you know your child will NOT be able to attend VBS?
Check all that apply
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