Online VBS Registration Form

First Presbyterian Church

611 Oakhurst Street -- Kernersville, NC 2728
336-993-7358

Vacation Bible School

June 25 – 28, 2018
5:30pm – 8:00pm
(supper provided)
 
Registration Form
(complete one for each child)
 
 

VBS Registration

Name:

Street Address:

City:     State:    Zip:

Home Telephone:    

Home Email:

Age:   Date of Birth:  

Last School Grade Completed: 

In Case of Emergency Contact:

Mother:   Phone Number:

Father:   Phone Number:

Other:    Phone Number:

Allergies or Other Medical Conditions:

Home Church: