VBS CAMPER REGISTRATION / June 4-8, 2018 / 9am-12pm
 
VBS CAMPER REGISTRATION / June 4-8, 2018 / 9am-12pm
2018 Shipwrecked VBS takes kids to an uncharted island and anchors them in the truth that Jesus carries us through life's storms. For children 4 yrs - 5th Grade
ONLY COMPLETED REGISTRATIONS WILL BE ACCEPTED: Please take the time to complete every write in field on the registration for each child you are registering for VBS.
PRICES PER CHILD: 1 Child = $35 / 2 Children = $55 / 3 Children = $65 / 4 Children = $75
How many Children Will Attend (use drop down menu for price additions per child added)  * 
1st Child’s Name (first & last)  * 
1st Child's Birthday (month, day & year) Ex: 1/1/2011  * 
1st Child's Age  * 
1st Child's Grade (Entering into the 2018-19 School Year)
1st Child's T-Shirt Size:  * 
1st Child: Any Allergies or Special Needs? If so list here:  * 
2nd Child's Name (first & last)
2nd Child's Birthday (month, day & year) Ex: 1/1/2011
2nd Child's Age
2nd Child's Grade (Entering into the 2018-19 School Year)
2nd Child's T-Shirt Size
2nd Child: Any Allergies or Special Needs? If so list here:
3rd Child's Name (first & last)
3rd Child's Child's Birthday (month, day & year) Ex: 1/1/2011
3rd Child's Age
3rd Child's Grade (Entering into the 2018-19 School Year)
3rd Child's T-Shirt Size:
3rd Child: Any Allergies or Special Needs? If so list here:
4th Child’s Name (first & last)
4th Child's Birthday (month, day & year) Ex: 1/1/2011
4th Child's Age
4th Child's Grade (Entering into the 2018-19 School Year)
4th Child's T-Shirt Size:
4th Child: Any Allergies or Special Needs? If so list here:
Parent Name (first & last)  * 
Parent Address (street, city, & zip code)
Parent Cell Number  * 
Emergency Contact Name and Cell Number (NOT A PARENT)  * 
I give Church of the Palms permission for use of photography including my child in church publicity.  * 
I would like to volunteer to help with VBS. If yes the Volunteer Registration Link will be sent to you.  * 
If you have any questions or about this online registration please contact Lisa at 941-924-1323 X208 or at LBaughman@churchofthepalms.org
Your Email Address  * 
Base Price $
Modifications $
Total $
 
 
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