Vacation Bible School

Rome Registration Form

Register for Vacation Bible School

June 5 through June 9, 2017

9 am until Noon

Full Name
*
Address
- Street Address
- Address Line 2
- City
- State / Province / Region
- Postal / Zip Code
- Country
Cell Phone Number
Phone Number
Email Address
Child's Age
*
Number of family members participating in Rome:
Will parents be helping in other areas of Rome?

Yes
No
Where?
IN CASE OF EMERGENCY, CONTACT:
*
Relationship to child:
Allergies or other medical conditions:
Home Church:
Name of a special friend your child might like to be with: