VACATION BIBLE SCHOOL

REGISTRATION FORM

New Heights Church 6385 N. Fresno Street Fresno, CA 83710 Vacation Bible School Registration Form 3 years through grade 6 July 8-12 6:00 p.m. - 8:30 p.m. PLEASE PRINT Child’s Name: First __________ Last _______________ Parents/Guardians Name: _________________________ Address: _____________________ City _____ Zip _____ Email: ________________@_______________________ Home phone: ___-___-_____ Cell: ___-___-_____ Date of birth: __/__/____ Age: __ Grade completed ___ Home church: ___________________________________ Allergies/medical information: ______________________ _________________________________________________ _________________________________________________ Emergency contact #1: ____________________________ Relationship: _____________________________________ Home phone: ___-___-_____ Cell: ___-___-_____ Emergency contact #2: ____________________________ Relationship: _____________________________________ Home phone: ___-___-_____ Cell: ___-___- _____ Authorized person/persons to pick up child after Vacation Bible School: ______________________________ Please return the completed form to the church. eMAIL BACK TO ADMIN@newheightsfresno.org