Grace Temple Baptist Church
2020 VBS Registration
(One Per Adult or Child Paticipant)
Name: Gender:
** Required Information for a child
Optional for Adults, Age range select one: 18-2930-3940-4950-5960-6970-over
** Child's age: ** Date of Birth: ** Last school grade completed
** Name of parent(s):
Street address:
City: State: Zip code:
Home Phone: Parent/caregiver's cell phone:
Email Address:
Home church:
Parent (s) work number:
Allergies or other medical conditions:
In case of emergency contact name:
Emergency contact number :
Relationship:
Registration information will be submitted to: vacationbibleschool@gracetemplebaptist.org