VBS REGISTRATION

 

June 23rd-27th

5:30PM - 8:30PM

Potty trained to 5th grade.

Child's name *
Child's name
Birthdate *
Birthdate
Address *
Address
Phone *
Phone
Emergency Phone *
Emergency Phone
Media Permissions *
I hereby grant permission for Journey Church to record sounds, images, or video of my child while attending this VBS program. I also give permission for Journey Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Journey Church in relation to this VBS program.
Parent/Guardian Digital Signature *
Parent/Guardian Digital Signature

Location

3782 North Bank Street
Kingman, AZ, 86409
United States