First Church of the Nazarene
Tuesday, May 22, 2018
Reaching. Fellowshipping. Caring.

VBS Registration Form

 
Child's Name
 
Child's Age        Date of Birth           Last grade completed
 
Name of Parent(s)
 
Street Address           
 
City & State                          Zip
 
Home Phone/Parent/Caregiver cell phone
 
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Allergies or other medical conditions
 
In case of emergency, contact
 
Phone                    Relationship to Child
 
I give my permission for RFC staff to obtain urgent medical care for my child