VBS is coming! Register now & get a free gift when you come!
Monday, July 10th, 2017 - Friday, July 14th, 2016, 9 - Noon
Gospel Lighthouse Church, 30 La Cross Street, Hudson Falls, NY 12839
Directions: https://goo.gl/maps/wTYMmiK1QC72

Please fill out a registration form for each child attending, Thank You!
Start
 
Child's Name: *

 
{{answer_26332064}} Gender *


 
{{answer_26332064}} Age *

 
{{answer_26332064}}Date Of Birth: *

 
{{answer_26332064}} Last School Grade Completed: *

 
Name of Parent(s): *

 
Home Address: *

 
Home Telephone:

 
Parent/Caregiver's Cell Phone *

 
Home Church:

 
Does {{answer_26332064}} Have Any Allergies or Medical Condition? If Yes, What? *

 
In Case Of Emergency:

Please include the Contact, Phone #, and relationship to {{answer_26332064}}
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