VBS | Mysite

Name of Child (Last name, first name)

Child's Age & Date of Birth

Name of 2nd Child (Last name, First name) Date of Birth, Grade Completed:

Name of 3rd Child (Last name, First name) Date of Birth, Grade Completed:

Name of 4th Child (Last name, First name) Date of Birth, Grade Completed:

Your child's address, including City & Zip code

Parent(s) or Guardian(s)' name:

Parent/Guardian's phone number:

Parent/Guardian's Email

Transportation

Walking

Parent/Guardian bringing child

Friend bringing your child (List below who can pick up your child)

Who is authorized to pick up your child, include ph#

Emergency contact & Phone #:

Known Allergies/Medical Problens:

Any additional siblings can be registured here (Include Name, Date of Birth and Grade complete)

Multi choice

I give my child(ren) permission to attend MRCCC's VBS Program (June 24-27, 2024). I also give permission for the MRCCC VBS staff to seek medical attention for my child if necessary while participating in VBS functions. By clicking, I agree.

Your signature:

Maple Rapids Congregational

Christian Church

Online Registration