The Church In Aurora -

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Vacation Bible School Registration Form

June 11 - 15, 2012

Register all minor-aged children,

including helpers and those to be placed in the Nursery.

Child's Name:

Grade: (Completed June 2012):

Age:

Allergies/Special Needs/Concerns:

Child's Name:

Grade: (Completed June 2012):

Age:

Allergies/Special Needs/Concerns:

Child's Name:

Grade: (Completed June 2012):

Age:

Allergies/Special Needs/Concerns:

Child's Name:

Grade: (Completed June 2012):

Age:

Allergies/Special Needs/Concerns:

Parent/Guardian Name:

Address:

Home Phone:

Work Phone:

Church Home:

Emergency Contact:

Physician Name/Phone:

The registration fee is $10 per child. This covers all activities, snack and one music CD per family.

This can be made payable to The Church in Aurora.