Events

Register for Keepers of the Kingdom Vacation Bible School!

Child's Name(Required)

Gender(Required)

Male

Female

Birthdate(Required)

xx/xx/xxxx FORMAT

Grade Completed(Required)

Address(Required)

Street, City, State, Zip

Parent/Guardian Name(Required)

Phone Number(Required)

Email(Required)

Emergency Contact(Required)

Relationship to Child(Required)

Emergency Contact

Phone Number(Required)

Emergency Contact

Who can pick up your child?(Required)

Name of Home Church

Any Food Allergies?(Required)

YES

If YES, Please List

Any Medical Concerns?(Required)

YES

If YES, explain

Andrea Yount

afyount@yahoo.com