Pleasant Ridge Evangelical Free Church

Welcome to VBS!

How Many Children Do you Want to Register?

Child First Name

Child Last Name

Child Birthdate

Child Grade (Right Now)

Second Child First Name

Second Child Last Name

Second Child Birthdate

Grade

Third Child First Name

Third Chid Last Name

Third Child Birthdate

Fourth Child First Name

Fourth Child Last Name

Fourth Child Birthdate

Fourth Child Grade

Do your children have any allergies?

Parent First Name

Parent Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code