Registration Form
*Required Fields
* Childs Name
* Childs Age
*Parents Name
*Address
*City  
*State
*Zip
*Phone #
e-mail Address
T-Shirt size- Please choose only one
Adult
Youth
Small
Small
Medium
Medium
Large
Large
x-Large
x-Large
Are there any particular medical problems your child may be experiencing
that we should be aware of?             
Allergies
Serious Illness  
Physical Disabilities  
Please explain in detail
How did you hear about our VBS?
Questions, comments, or feedback:
MT. Pisgah Baptist Church,  Cumming, GA
June 2nd - 6th
7:00 - 9:00