Vacation Bible School Registration
Church of God
45814 Lewis Avenue, Chilliwack BC V2P 3C4
• Ph: 604 792 9400 • Fax: 604 792 9490
• Email: vbs@chilliwackchurchofgod.com
  July 5-9, 2010 FREE ADMISSION
Name of Child:
Name of Child:
Date of Birth:
Date of Birth:
Shoe size:
Shoe size:
Grade completed in June 2010:
Grade completed in June 2010:
       
Name of Child:
Name of Child:
Date of Birth:
Date of Birth:
Shoe size:
Shoe size:
Grade completed in June 2010:
Grade completed in June 2010:
       
Name of Parent or Guardian:
Home church, if any:
Address:
    
Home Phone:
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Alternate Phone:
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Doctor's Name:
Email Address:
Phone:
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Person(s) to contact in case of emergency:
Name:
Name:
Phone:
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Phone:
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Do any of your children have special needs or food allergies?
Questions / comments