VBSRegistrationForm - Community Baptist Church of Whitefield, NH

VBS REGISTRATION FORM 2011

Print the form below and fill it out and
mail it to or drop it at the church
or bring the form to VBS

-----------------------------------print form below & cut here----------------------------------

Pandamania

Vacation Bible School

Community Baptist Church

Whitefield, NH

August 8 – 12, 2011 6 - 8:30pm

Sunday August 14 9:30am

(603) 837-2469

cbc1816@myfairpoint.net

www.cbc1816.org

REGISTRATION

Name________________________________________________________ Staff [ ] Student [ ]

Age________ Date of Birth_________________ Grade (completed)_____________

Street Address_________________________________________________________________________

Mailing Address _______________________________________________________________________

Town/City_______________________________ State________ Zip_____________

Phone (home)___________________________ Phone (cell/other)_______________________________

Home e-mail __________________________________________________________________________

Mother’s name___________________________ Father’s name_________________________________

In case of emergency during VBS, contact __________________________________________________

Allergies/medical conditions______________________________________________________________

Home church__________________________________________________________________________

Name of a special friend that your child might like to be with__________________________________

Other:

Attendance

Mon

Tue

Wed

Thu

Fri