stellar: Shine Jesus’ Light VBS 2023

Child's Name:

Grade (for the 2024-2025 school year):—Please choose an option—Pre-SchoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade

Age:

Shirt Size (Register by Monday, May 20th in order to receive a t-shirt. After that date, only a limited number of shirt sizes will be available.): —Please choose an option—Youth Extra SmallYouth SmallYouth MediumYouth LargeYouth Extra LargeAdult SmallAdult MediumAdult LargeAdult Extra Large

Street Address:

City:

State:

Zip Code:

Parent/Guardian Name:

Parent/Guardian Email:

Parent/Guardian Cell Phone:

Emergency Contact Number:

Allergies or Special Needs:

Is anyone else allowed to pick up your child? (Please list names below):
Can photographs be taken of this child? (Photos may be used on the church website, Facebook page, etc. Names of children will not be posted): —Please choose an option—YesNo
Additional Comments:

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