PCBC - Vacation Bible School

Vacation Bible School 2012

Join the
K.I.D.S. Backyard Club

VBS Scripture:
Matthew 18:11 For the Son of Man has come
to save that which was lost.

June 18th - June 22nd
6:30-9:00 PM

Open to all 3 year olds through 6th grade
To register for VBS, please complete the requested information.

Welcome to the VBS Registration Page!
We are excited to have you join us this
year as we Investigate and Discover truths from Scripture!

Please select your child's age group:

CHILD'S INFORMATION
Child's First Name:
*
Last Name:
*
Child's Birthdate:
*
Last Grade Completed:
*
Address:
*
Address 2:
City:
*
State:
*
Zip Code:
*
Home Phone:
*

VBS T-Shirts For Sale $7.00ea

Child Small (6-8)
Child Med (10-12)
Child Lrg (14-16)
Child XL (18-20)
Adult Small (34-36)
Adult Med (38-40)
Adult Lrg (42-44)
Adult XL (46-48)
Adult XXL

PARENT INFORMATION
Parent's Name:
*
Parent's Work /Cell Phone:
*
Parent's Email (if applicable):
2nd Parent's Name:
2nd Parent's Work/Cell Phone:
2nd Parent's Email (if applicable):

EMERGENCY CONTACT
Name:
*
Relationship:
Phone:
*

HEALTH INFORMATION
Please list any allergies or medical conditions of your child. If None please type N/A.
*
Doctor's Name:
*
Doctor's Phone:
*

GENERAL INFORMATION
Name of Home Church:
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