VBS - Grace Church

Grace Kid's Club
July 2, 9, 23, 30 & Aug 13th
6pm - 8pm

Register for Grace Kid's Club!

* Indicates required field

Child's Name *

First

Last

Parents/Guardian *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Age *

Email *

Phone Number *

Allergies/Special Directions for Child *

Emergency Contact (Name & Phone #) *

By electronically submitting this form, I hereby acknowledge and agree that I am placing my child in the care of Grace OPC for the purpose of their VBS program and in so doing I agree to, and hereby do release Grace OPC and their staff from any and all liability for any incident, accident or occurrence which may take place involving my child, including but not limited to any resulting injury, illness or disease which my child may suffer as a result of attending VBS at Grace OPC. (Name of Parent/Guardian submitting form) *

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Grace Kid's ClubJuly 2, 9, 23, 30 & Aug 13th6pm - 8pm

Register for Grace Kid's Club!

Grace Kid's Club
July 2, 9, 23, 30 & Aug 13th
6pm - 8pm