Vacation Bible School 2010 Saddle Ridge Ranch
July 11th-16th from 6:00 - 8:30 pm.
Ages - 3 trhought completed Pre-K and Kindergarten through completion of 6th grade
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Child's First Name
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Child's Last Name
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Address1
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Address2
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City
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State
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Zip
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Home Phone Number
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Email
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Child's Birth Date
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Day
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Year
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On July 11th 2010 what will be the last grade your child has completed in school
Not in school yet
Entering Kindergarten
Completed Kindergarten
Completed 1st
Completed 2nd
Completed 3rd
Completed 4th
Completed 5th
Completed 6th
Completed 7th
Completed 8th
VBS Worker's Child(under3)
Please select an item.
What church do you attend?
None
Kennebec Baptist
Pleasant Grove
Fuquay Baptist
Angier Baptist
C3
Rawls Baptist
Fuquay-Varina Methodist
Angier Methodist
Hilltop Baptist
Piney Grove-Fuquay
Piney Grove Chapel-Angier
New Hope Presbyterinan
Fellowship Baptist
Other
Do you go to Sunday school?
Yes
No
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?
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Emergency contact name
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Emergency contact phone
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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.
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9808 Kennebec Church Rd. Angier, NC 27501 (919)639-4021
info@kennebecbaptist.org
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