VBS Registration
First Baptist Church of Palmyra is hosting Vacation Bible School for students ages 4-12. This year's VBS is June 24-28 Monday through Friday from 6:00-8:00pm. We will have music, crafts, snacks, games, and gospel saturated lessons. Please complete this form for each child participating in VBS. Each child must have this completed by a parent or guardian prior to enrollment.
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Email *
Child's First & Last Name *
Grade entering this Fall: *
Age *
Address *
Father/Guardian Name *
Mother/Guardian Name *
Father/Guardian cell phone *
Format ###-###-####
Mother/Guardian cell phone *
Format ###-###-####
Father/Guardian email address *
Mother/Guardian email address *
Emergency contact if parents or guardians cannot be reached *
Secondary emergency contact if parents or guardians cannot be reached
Emergency contact phone *
Format ###-###-####
Medical or food allergy information *
Please indicate any special needs or dietary restrictions
What are the names of people to whom we can release your child? *
We will not release your child to anyone other than the parents and guardians listed above or those listed below
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