For Kids Leaving K - Entering 6th Grade
Please provide information in all of the fields below.

Name:
Address:
City:
State:
Zip:
Home phone:
Select:	Male    Female
Age:
Last school grade completed:
Mother's name:
Father's name:
Emergency contact name:
Emergency contact phone:
Allergies or other medical conditions:
Home church:
Special friend your child might like to be with:
If you would like to preorder a VBS T–Shirt for $10, please indicate shirt size
Y Small    Y Medium    Y Large    Y XL