a special place of hope and purpose

Outrigger Island - 2008 Registration
Granite Baptist Church, Milford NH

Child's Name:

Parent/Guardian:

Address:

City, State:

Zip Code:

Home Phone:

Cell Phone:

Email:

Date of Birth:

School Grade (completed):

Where do you attend Church?:

How did you hear about VBS?
Is there any medical information, physical restrictions or food allergies we should know about?


What are the names and ages of other siblings attending VBS?


Telephone Number(s) where parent/guardian(s) may be contacted during VBS:
Work:

Pager:

Cell Phone:

Another person to notify in case of an emergency:
Name of Person

Relationship

Phone Number

 

 

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