Rumple Church VBS 2017 Registration

Complete the form below and join us for VBS 2017, ALIVE: Living and Learning with God's Creation

Child's First Name *

Child's Last Name *

Grade just completed *

Child's age at time of VBS *

Child's T-Shirt Size *

Address 1 *

City *

State *

Zip *

Phone *

Parent's Name(s) *

Best Contact Number *

Parent's Email Address *

Additional information

Please check all that apply and explain in the "other" box

Takes medication while at VBS	Allergic to insect bites
Food Allergies	Other Other

Please tell us anything you think we should know about your child