Vacation Bible School 2009
On-Line Registration
Contact Information
Parent's First Name :
Parents's Last Name:
Street Address:
City:
State:
Zip Code:
Phone Number:
Cell Number:
Email Address:
Do you attend GPBC:
YES
NO
OCCASIONALLY
Emergency Contact other than parent:
Full Name & Phone
Person(s) other than yourself authorized to pick up your child:
Full Name
Will a parent/emergency contact be on the premises?
YES
NO
If YES,who?
Throughout this week, several children will be photographed. These pictures may be used in various newspapers, as well as in our closing program slide show.
Please select one below:
YES
, my child(ren)'s pictures may be published in newspapers or used in the slide show.
NO
, my child(ren)'s pictures may not be published in newspapers or used in the slide show.
Children Information
First & Last Name :
M -
F
Date of Birth:
Age
VBS Class:
Select Class
4 OR 5 Yrs Old (by 10/1/09) Not entering Kindergarten
Entering Kindergarten (in Sept.2009)
Finished Kindergarten (in June 2009)
Finished 1st Grade (in June 2009)
Finished 2nd Grade (in June 2009)
Finished 3rd Grade (in June 2009)
Finished 4th Grade (in June 2009)
Finished 5th Grade (in June 2009)
Allergies / Medical Conditions:
First & Last Name :
M -
F
Date of Birth:
Age
VBS Class:
Select Class
4 OR 5 Yrs Old (by 10/1/09) Not entering Kindergarten
Entering Kindergarten (in Sept.2009)
Finished Kindergarten (in June 2009)
Finished 1st Grade (in June 2009)
Finished 2nd Grade (in June 2009)
Finished 3rd Grade (in June 2009)
Finished 4th Grade (in June 2009)
Finished 5th Grade (in June 2009)
Allergies / Medical Conditions:
First & Last Name :
M -
F
Date of Birth:
Age
VBS Class:
Select Class
4 OR 5 Yrs Old (by 10/1/09) Not entering Kindergarten
Entering Kindergarten (in Sept.2009)
Finished Kindergarten (in June 2009)
Finished 1st Grade (in June 2009)
Finished 2nd Grade (in June 2009)
Finished 3rd Grade (in June 2009)
Finished 4th Grade (in June 2009)
Finished 5th Grade (in June 2009)
Allergies / Medical Conditions:
First & Last Name :
M -
F
Date of Birth:
Age
VBS Class:
Select Class
4 OR 5 Yrs Old (by 10/1/09) Not entering Kindergarten
Entering Kindergarten (in Sept.2009)
Finished Kindergarten (in June 2009)
Finished 1st Grade (in June 2009)
Finished 2nd Grade (in June 2009)
Finished 3rd Grade (in June 2009)
Finished 4th Grade (in June 2009)
Finished 5th Grade (in June 2009)
Allergies / Medical Conditions:
First & Last Name :
M -
F
Date of Birth:
Age
VBS Class:
Select Class
4 OR 5 Yrs Old (by 10/1/09) Not entering Kindergarten
Entering Kindergarten (in Sept.2009)
Finished Kindergarten (in June 2009)
Finished 1st Grade (in June 2009)
Finished 2nd Grade (in June 2009)
Finished 3rd Grade (in June 2009)
Finished 4th Grade (in June 2009)
Finished 5th Grade (in June 2009)
Allergies / Medical Conditions:
Adult Devotional Sign-up (9:30 - 10:30)
Full Name
Full Name
Full Name
Junior/Senior High Helpers
Sign-up
Full Name
Grade
Full Name
Grade
Full Name
Grade