First Church of the Nazarene
Thursday, June 21, 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
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