Till we all come in the unity of the faith, and of the knowledge of the Son of God, unto a perfect man, unto the measure of the stature of the fulness of Christ: - Ephesians 4:13
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Name of Child 1:
Sex:
Mother's Name:
Father's Name:
Address:
City:
Zip Code:
State:
Medical Action:
List allergies, medications, special needs or dietary reactions:
Name:
Church Affiliation:
Work #:
Cell #:
Home #:
VBS REGISTRATION 2018 - This is a Free Event
Thursday July 26, 2018 - 7PM -9PM
Friday July 27, 2018 - 7PM - 9PM
Saturday July 28, 2018 - 10AM - 4PM
Name:
Doctor's Name:
Telephone:
Photo Release:
Relation to Child:
Phone Number:
Relation to Child:
Phone Number:
**Your child’s pictures may be used within the church.
Name:
Relation to Child:
Phone Number:
Additional contacts in case the parent (guardian) cannot be reached
Redeemed Church of Jesus Christ |9552 James Madison Hwy | Warrenton, VA 20186 |540-935-2956
Name of Child 2:
Sex:
Name of Child 3:
Sex:
Child 1:
Child 2:
Child 3:
