VBS Register

June 24-28 | www.nhbcmineola.com/vbs
email children@nhbcmineola.com

Registration

Child's Name

*

Birthdate

*

Last Grade Completed

*

Please select one option.

PreK Kinder First Second Third Fourth Fifth

Medical or other information we need to know. (Please include food allergies.)

*

Parent/Guardian Name

*

Cell Phone

*

Emergency Contact Name and Phone Number (other than previously listed)

*

Who may pick up your child at the end of each VBS day?

*

Does your child attend church? If so, where? (Put N/A if none)

*

If your child is visiting New Hope, who is he/she a guest of?

Additional Child(ren)

Name

Birthdate

Last Grade Completed

Please select one option.

PreK Kinder First Second Third Fourth Fifth

Medical or other information we need to know. (Please include food allergies.)

Name

Birthdate

Last Grade Completed

Please select one option.

PreK Kinder First Second Third Fourth Fifth

Medical or other information we need to know. (Please include food allergies.)

Name

Birthdate

Last Grade Completed

Please select one option.

PreK Kinder First Second Third Fourth Fifth

Medical or other information we need to know. (Please include food allergies.)

Name

Birthdate

Last Grade Completed

Please select one option.

PreK Kinder First Second Third Fourth Fifth

Medical or other information we need to know. (Please include food allergies.)

Description

June 24-28

www.nhbcmineola.com/vbs
email children@nhbcmineola.com

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