Discovery on Adventure Island

Child's Name

First Name *

Last Name *

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Child's Date of Birth (Required)

Grade Completed (Required)

Pull down and select one

Child's Age (Required)

Child's Gender (Required)

Special Needs / Allergies / Medical Information

Parent/Guardian's Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Mailing Address (if different than above)

Primary Phone# (Required)

Does this PRIMARY phone# accepted TEXT messages?

Yes
No

Secondary Phone#

Does this SECONDARY phone# accepted TEXT messages?

Yes
No

Email Address (Required)

Emergency Contact

First Name *

Last Name *

Emergency Contact Phone# (Required)

Does this Emergency Contact phone# accepted TEXT messages?

Yes
No

Person responsible for pickup after VBS (Required)

Phone# (Required)

Relationship to child (Required)

Does this Contact phone# accepted TEXT messages?

Yes
No

T-Shirt size needed (Required)

Pull down to choose size

• Do you agree to allow photos of your child to be used in church presentation or church promotional materials?

Yes
No

Would you like to purchase a VBS music CD?

Yes
No

How did you learn about GCPC's VBS Program? (Required)

Questions & Comments

Discovery on Adventure Island

Quest for God’s Great Light!

Vacation Bible School, June 6-10
Ages 4 yrs – 5th Grade

VBS REGISTRATION

Explorer's Information

Parent / Family / Guardian Information

Emergency Contact Information

VBS Pick-Up Information

T-shirt Size

Photo Release

VBS Music CD - $5

Discovery on Adventure Island

Quest for God’s Great Light!

Vacation Bible School, June 6-10 Ages 4 yrs – 5th Grade

VBS REGISTRATION

Explorer's Information

Parent / Family / Guardian Information

Emergency Contact Information

VBS Pick-Up Information

T-shirt Size

Photo Release

VBS Music CD - $5

Vacation Bible School, June 6-10
Ages 4 yrs – 5th Grade