Bethany Vacation Bible School 2022 - Bethany House of Worship

Select number of children attending VBS 2022 *

Child's Name *

Grade in Fall 2022 *

Age on June 27, 2022 *

Child # 2 Name *

Child # 2 Grade *

Child # 2 Age *

Child # 3 Name *

Child # 3 Grade *

Child # 3 Age *

Child # 4 Name *

Child # 4 Grade *

Child # 4 Age *

Child # 5 Name *

Child # 5 Grade *

Child # 5 Age *

Child # 6 Name *

Child # 6 Grade *

Child # 6 Age *

Child # 7 Name *

Child # 7 Grade *

Child # 7 Age *

Check Date(s) Attending *

Parent's Name *

First

Last

Parent's Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Parent's Cell Phone *

Would you like to add an emergency contact apart from the parent?

Emergency Contact *

First

Last

Emergency Contact Cell *

How will your child be attending the VBS? *

Do you agree to allow photos / video of your child to be taken during the VBS?

Are you currently a member of Bethany House of Worship?

Do you wish to receive information about church events throughout the year?

Is there anything else we need to know about your child such as food allergies/medical needs/travel needs? *