Eastside Church of Christ VBS 2016

Please use this form to register up to 5 people for VBS June 17-21st 7:00 pm.
See size reference chart below.

* Indicates required field

Parent/Guardian Name *

Email *

Address / City / State / Zip *

Cell Phone *

Home Phone *

Emergency Contact (Name & Phone) *

Emergency Contact (Name & Phone) *

Please provide individual information for up to
5 people for class registration & t-shirt size.

Age/Grade or Adult

Name *

First

Last

Grade *

Name *

First

Last

Grade *

Name *

First

Last

Grade *

Name *

First

Last

Grade *

Name *

First

Last

Grade *

Please list any medical Information along with Person's name (i.e. James - allergic to peanuts) *

I agree to receiving marketing and promotional materials

Submit