VBS-Registration

Orangevale church of Christ
5915 Main Avenue
Orangevale, CA 95662
916-988-2011

You may register using the online form below or download the registration form, print it, fill it out, and return by mail or in person to the Orangevale church of Christ on or before our VBS dates.

Register:

PARENT INFORMATION
Parent First/Last Name (required)

Parent Mailing Address (required)

Parent Email (required)

Parent Phone (required)

Parent Home Church

Emergency Contact During VBS (required)

Emergency Phone (required)

CHILDREN INFORMATION
Child#1 First/Last Name (required)

Child#1 Age (required)

Child#1 Grade Completed 2018-2019 (required)

Child#1 List Any Food Allergies, Medical Concerns, Needs

If you are only registering one child you may skip down to the doctor/hospital information below.

Child#2 First/Last Name

Child#2 Age

Child#2 Grade Completed 2018-2019

Child#2 List Any Food Allergies, Medical Concerns, Needs

Child#3 First/Last Name

Child#3 Age

Child#3 Grade Completed 2018-2019

Child#3 List Any Food Allergies, Medical Concerns, Needs

Child#4 First/Last Name

Child#4 Age

Child#4 Grade Completed 2018-2019

Child#4 List Any Food Allergies, Medical Concerns, Needs

In the event you cannot be reached to make arrangements for emergency medical attention, you authorize the Orangevale church of Christ staff member in charge to take your child to:
Doctor Name

Hospital Name

Hospital Address

Hospital Phone

ADDITIONAL INFORMATION
Do you give the Orangevale church of Christ permission to use your child's photo for our promotional use (Facebook, church web site, VBS PowerPoint)?
YesNoDepends Upon Photo

Are you interest in learning more about the Orangevale church of Christ?
YesNo

Are you interest in a personal Bible study?
YesNo

Any Addition Comments