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Vacation Bible School * June 17-21 * Registration
Age 3 thru 4th grade
VBS Registration
Name
Email
Address
Street
Street, Line 2
City
State
Zip Code
Phone
Grade Entering?
Age? (Child must be age 3 by June 1, 2024)
Boy/Girl?
Birth Date?
Parent or Guardian Name(s)?
Emergency Contact?
Emergency Contact Phone Number?
Do you attend Sunday School? Central Baptist or Other?
If visiting our church, who are you a guest of?
Special Instructions (food allergies, etc.)
Who may pick up your child at the end of each VBS day?
Photograph/Video permission for your child? (Y/N)
(select an option)
Yes
No
Permission to use your child's photograph/video for your promo purposes? (Y/N)
(select an option)
Yes
No
T-Shirts available thru christianbook.com or concordiasupply.com
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130 Providence Road,
Oak Ridge, TN 37830
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