| Calvary Chapel Frederick |

VBS Registration 2010


Welcome to VBS Registration for Calvary Chapel Frederick! Please note the following: Age Limit: VBS is open to children ages 4 to 11 only. Privacy: Personal information entered on this form will ONLY be used for the purpose of registration for Vacation Bible School at Calvary Chapel Frederick.
CHILD INFO:
Child's Name	*	*
Birth Month	*
Birth Date	*
Birth Year	*
Grade Completed	*
Gender	*	Boy Girl
Street Address	*
Address Line 2
City	*
State/ZIP	*	*

PARENT/GUARDIAN INFO:
Name	*
Home Phone	*
Cell Phone
Work Phone
Email	*

EMERGENCY CONTACT:
Name	*
Relationship to Child
Phone	*

ADDITIONAL INFO:
Please place my child with
Home church
List Any Food Allergies
List Any Medical Concerns