Havana Southern Baptist Church
Sunday, May 26, 2019

2019 VBS - ONLINE Registration Form

 
 
 
 
 
                       Grades 1-6

 

Complete Information Below:

 
 
 
 
 

Phone Numbers:

 
     
 

Age Information:

Grades 1st - 6th
 
  
 

Medical Information:

 
Medical or other information we need to know. (Please include any food allergies.)
 
 

Emergency Contact:

 
  
 
  
 
 

Dismissal Information:

 
Who may pick up your child at the end of each VBS day?    
 
 

Other Information:

 
Do you attend Sunday School?    If yes, where?  
 
May we have permission to photograph your child? 
May we have permission to use your child's photograph in church publications for the purpose of promotion? 
 
 
 
  
 
 

DATES:  June 17 - June 21, 2019 - 6:00 p.m. to 8:30 p.m. each evening.
                  Sunday June 23, 2019 - 6:00 p.m. - Family night.

 

LOCATION:  Havana Southern Baptist Church, 425 N Pearl, Havana IL

For more information contact Don Full at 217-652-3076.