Vacation Bible School Registration!

Child's Name *

First

Last

Age *

Birthday? *

School Grade Completed? *

Home Address *

City, State, Zip *

Home Phone Number *

E-mail *

Please enter your email, so we can follow up with you.

How will your child(ren) get to VBS? *

Will your child be riding the EBC Van? *

Parent's/Guardian's Names? *

Cell Phone Numbers?

Work Phone Numbers?

Other Emergency Contact Numbers?

Does child attend church regularly?

Name of church?

How Did You Learn About EBC’S VBS?

Any Additional Information Pertinent To Your Child’s Care or Well Being ?

Website