VBS REGISTRATION — CORNERSTONE ASSEMBLY OF GOD

MY TALENTS SERVE GOD - JULY 21-23, 2025

Vacation Bible School Registration Form

All children Kindergarten through 5th grades are welcome! Doors will open for students to check-in at 5:15pm and dismissal will be at 8:00pm daily. Please fill out the form below to register your child.

Child's Name

First Name

Last Name

Gender

Male

Female

Age

Please note: Children must be entering kindergarten through 5th grade to attend.

Grade

Grade your child will be entering into in the Fall (Kindergarten - 5th Grade)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Medical conditions/allergies?

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Phone Number

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Parent/Guardian Email

Emergency Contact Name

First Name

Last Name

Relationship to child

Emergency Contact Phone Number

(###)

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Please list the names of the people who may pick up your child.