NextGen Kids' Ministries

VBS Registration 2017

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Registration Form
Maker Fun Factory VBS 2017
June 26-29
6PM - 8:30PM
Ages 4 thru Grade 5
(*students who just completed grade 5)
Suggested Registration fee - $10 per student / $25 per family

Registration payment available through the link on our web home page (PushPay)
or via Cash, Credit/Debit, or Check on the first night of VBS

STUDENT Name *

Date of Birth *

Grade entering in Fall 2017 (if applicable)

PARENT / Guardian Name *

Address *

Phone *

Email *

ALLERGIES?

Emergency Contact 1 *

Emergency Contact 1 Phone *

Emergency Contact 2

Emergency Contact 2 Phone

ADDITIONAL NOTES about your student we should know?

Registration donation / Student

Please use this feature when adding a suggested registration fee if you are only registering one student. (Suggested registration donation - $10 per student)


Registration donation / Family

Please use this feature if registering multiple students per family. (Suggested registration donation - max. $25 per family)


Scholarship Requested


Unavailable
* required