15825 North 35th Avenue Phoenix, AZ 85053 Phone 602.863.0945 office@palmcroft.com
Kids Focus Home | Your First Visit | Nursery | Preschool | Elementary | Camps
VBS 2008 Online Registration Form
$10.00 registration fee per child, with a maximum of $30 per family.
This registration fee covers all VBS activities and 1 CD of the music we'll sing during the week! (1 CD per family )
Parents/Guardians First & Last Names: Address: City: State: Zip Code: Email: Home Phone: Cell Phone:
KINDERGARTEN-6TH GRADE
(Nursery and Preschool available for volunteers only-they must also be registered)
Child's Name: Birthdate: Last Grade Completed: K 1 2 3 4 5 6 Age: Infant Crawler Walker 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years Gender: M F Shirt size: No T-shirt Child XS (2-4) Child S (6-8) Child M (10-12) Child L (14-16) Adult S Adult M Adult L Adult XL Adult XXL
Child's Name: Birthdate: Last Grade Completed: K 1 2 3 4 5 6 Age: Infant Crawler Walker 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years 11 Years 12 Years Gender: M F Shirt size: No T-shirt Child XS (2-4) Child S (6-8) Child M (10-12) Child L(14-16) Adult S Adult M Adult L Adult XL Adult XXL
Do you regularly attend church? Yes No If yes, where?
Medical, allergy, or other information we need to know:
Emergency contacts: Name: Phone: Name: Phone:
