Vacation Bible School 2022

Student Information

Name

Gender

Male Female

Birthday

Grade (Fall 2022)

Parental/Legal Guardian Information

Primary Guardian #1

Relationship to Child

This address will receive a confirmation email

Phone Number

Address

Alternate Guardian #1

Relationship to Child

Phone Number

Alternate Guardian #2

Relationship to Child

Phone Number

Medical Information

Please list all allergies -- or type 'none' if there are none

Does your child carry an epi-pen? (please note: if yes, it is the responsibilty of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)

Yes No

Please list all medical concerns -- or type "none" if there are none

Description

July 24th-27th, Sunday-Wednesday. 6:00pm-8:00pm

Vacation Bible School will be held at Living Hope Church 2722 Springbrook Rd. Medford, Oregon 97504.
Grades 1st-6th.
Drop off will be at 6:00pm and pick up will be at 8:00pm.

Vacation Bible School 2022

Description

Please Fix the Following