Vacation Bible School Registration

Father/Guardian Name

Mother/Guardian Name

Child/Children's Names and Grade

Address

Home telephone

Cell phone

Home e-mail address

Number of family members participating in Egypt

Will parents help in other areas of Egypt?

Yes No

Where?

In case of emergency, contact:

Allergies or other medical conditions

Home Church

Egyptian Family Name (for church use only)

Name of a special friend your child might like to be with

Please list any medical allergies, medications being taken, medical problems, other pertinent information

College Place Village Church