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Richfield VBS Registration
5:30pm-8:00pm; July 8-11, 2018. Ages 4 yrs-old through completed 5th Grade.
Please fill out a separate form for each child. If you have a question, call the church at 254-772-2340.
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ROAR 2019!!!
Child's Name
*
Your answer
Child's Age
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Your answer
Child's Completed Grade in School
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Your answer
Child's Gender
*
Female
Male
Parent Name(s)
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Your answer
Street Address
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Your answer
City, State, Zip Code
*
Your answer
E-mail Address
Your answer
Phone number(s) (Cell Preferably)
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Your answer
Emergency Contact Besides Parent
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Your answer
Emergency Contact Relationship to Child
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Your answer
Emergency Contact Phone Number
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Your answer
Child's Allergies or "None"
*
Your answer
Home Church
Your answer
Name(s) of person(s) who may pick up child
Your answer
Name of friend your child might want to be with
Your answer
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