Pearl Baptist Church VBS Registration Form 2024

First name

Last name

Phone

Address

Child's First Name

Child's Last Name

Child's Birthdate

Grade Completed in School in Spring 2024 (Please Choose One)

Medical or any other information that we need to know (Please include any food allergies)

Do you have additional children to register?

Yes

Child's First Name

Child's Last Name

Child's Birthdate

Grade Completed in School in Spring 2024 (Please Choose One)

Medical or any other information that we need to know (Please include any food allergies)

Do you have any addtional children to register?

Yes

Child's First Name

Child's Last Name

Child's Birthdate

Grade Completed in School in Spring 2024 (Please Choose One)

Medical or any other information that we need to know (Please include any food allergies)

Do you have additional children to register?

Yes

Child's First Name

Child's Last Name

Child's Birthdate

Grade Completed in School in Spring 2024 (Please Choose One)

Medical or any other information that we need to know (Please include any food allergies)

Do you have additional children to register?

Yes

Child's First Name

Child's Last Name

Child's Birthdate

Grade Completed in School in Spring 2024 (Please Choose One)

Medical or any other information that we need to know (Please include any food allergies)

Emergency contact if different than above

Phone

Is there anyone restricted from picking up your child(ren)?

Does your child(ren) attend a church? If so, where?

If your child(ren) is visiting our church, who are they a guest of?

May we have permission to photograph your child and use it for purposes of promotion?

Yes

If you have any questions, please contact us at information@pearlbaptistchurch.org

ADDRESS

704-735-2038

4657 E Highway 27

Iron Station, NC 28080

information@pearlbaptistchurch.org

bottom of page