VBS Jerusalem Marketplace

Name

Please note, VBS is for kids ages 3 - 5th grade. Kids must be 3 years old by July 1, 2022. Thank you!

Name

Gender

Male Female

Grade Completed

Age

Address

Additional Addresses

This address will receive a confirmation email

Phone

Additional Phone(s)

Number of family members participating in VBS

Will parents be helping in any areas of VBS?

Yes No

If "yes" was marked on the last question, where or what area?

In case of emergency, please list at least 2 contacts with phone numbers

Home Church

Please list allergies and all other medical conditions . (If there is more than one child, please put child's name beside each one)

Description

Please fill out this form and click submit.