Vacation Bible School

Vacation Bible School (VBS)

June 18-22, 2018, 9am-12pm

Ages 3 to High school and the cost is FREE!

If you have any questions contact:

Shelley Canfield: shelley.canfield@gmail.com

or Heidi Franz: heidifranz1@gmail.com.

Please Fill Out All Required Fields

Child's Name

First Name*

Last Name*

Child's Gender

Child's Age

Required*

**ALL PRESCHOOLERS MUST BE POTTY TRAINED!**

Date of Birth

Required*

Last School Grade Completed

Name of Parent(s)

First Name*

Last Name*

Address

Street 1*

Street 2

City*

State*

Zip*

Home Phone

Required* --

Parent/Caregiver's Cell Phone

Required* --

E-mail

Release

Required*

By clicking "yes", you are authorizing release for pictures of child to be on ICC website/ newsletter.

Home Parish

Allergies or Other Medical Conditions

Required*

In Case of Emergency Contact:

Required*

Emergence Phone

Required* --

Pick Up

First Name*

Last Name*

Who will be responsible for picking up child?

Pick Up Phone

Required* --

Relationship to Child

Required*

CREW LEADER: Grades 6 - High School

There will be a mandatory orientation meeting for all Crew Leaders on Sunday, June 10 at 12:30pm.

Help With

	Preschool
	School Age

Vacation Bible School

Vacation Bible School (VBS)

June 18-22, 2018, 9am-12pm

Ages 3 to High school and the cost is FREE!

If you have any questions contact:

Shelley Canfield: shelley.canfield@gmail.com

or Heidi Franz: heidifranz1@gmail.com.

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