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Richfield VBS Registration
5:30pm-8:00pm; July 20-22, 2016.
Please fill out a separate form for each child, including youth and young adults who plan on attending Rev. Alec's class.
If you have a question, call the church at 254-772-2340.
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* Indicates required question
Child's/Youth's Name
*
Your answer
Child's/Youth's Age
*
Your answer
Parent Name(s)
*
Your answer
Address including City, State, Zip
*
Your answer
E-mail Address
Your answer
Phone number(s) (Cell Preferably)
*
Your answer
Emergency Contact Besides Parent
*
Your answer
Emergency Contact Phone Number
*
Your answer
Child's/Youth's Allergies or "None"
*
Your answer
Home Church
Your answer
Name(s) of person(s) who may pick up children
Your answer
Name of friend your child might want to be with
Your answer
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