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Vacation Bible School 2008 Outrigger Island

August 3 - August 8, 2008 6-8:30 PM

Ages - Entering Kindergarten through completion of 8th grade

*	Child's First Name
*	Child's Last Name
*	Address1
	Address2
*	City
*	State
*	Zip
*	Home Phone Number
*	Email
*	Child's Birth Date	Day Month Year
*	On August 3rd 2008 what will be the last grade your child has completed in school
	What church do you attend?
	Do you go to Sunday school?
	Mother's name
	Mother's contact phone number or Cellular
	Father's name
	Father's contact phone number or Cellular
	Does child have any medical conditions or alergies that require special attention? If yes, explain:

	In the event of an emergency, who should be called?
*	Emergency contact name
*	Emergency contact phone

*	Do we have your permission to get emergency medical care for your child if neccessary?	yes no

Please be patient, do not click 'Enroll Me' more than once.

9808 Kennebec Church Rd. Angier, NC 27501 (919)639-4021 info@kennebecbaptist.org -view map-