TrueRassic Park
Vacation Bible School Registration
June 9-13, 2008
Names and Ages of Children Being Registered
Child one Grade Finished Date of Birth
Child two Grade Finished Date of Birth
Child three Grade Finished Date of Birth
Child four Grade Finished Date of Birth
Child five Grade Finished Date of Birth
Parent/Guardian Names
Address CityZip Code
Home PhoneCell Phone
Email
Emergency Contact Name Emergency Contact Phone
Do we have permission to photograph your child? Yes No
Medical/Allergy Information (give name of child and details in comment box below)
Name of person with permission to pick up your child(ren)
Name of church you attend if any?