Vacation Bible School Registration

Transfers are available for $1.50 at the Children's Ministry Desk.

Parents Name:    
Address:            
City, State, Zip   
Home Phone #    Unlisted
Work Phone #   
Cell Phone #      
Email                 

Children's Names:
Child #1 
Name Age Male     Female
Allergies (including food) or other medical conditions:

2009/2010School Year Grade Completed:
K     1     2     3    4     5
Name of home church:
Invited by:                   

Child #2
Name Age Male     Female
Allergies (including food) or other medical conditions:

2009/2010 School Year Grade Completed:
K     1     2     3    4     5
Name of home church:
Invited by:                   

Child #3
Name Age Male     Female
Allergies (including food) or other medical conditions:

2009/2010 School Year Grade Completed:
K     1     2     3    4     5
Name of home church:
Invited by:                   

Child #4
Name Age Male     Female
Allergies (including food) or other medical conditions:

2009/2010 School Year Grade Completed:

K     1     2     3    4     5
Name of home church:
Invited by:                   

Child #5
Name Age Male     Female
Allergies (including food) or other medical conditions:

2009/2010 School Year Grade Completed:
K     1     2     3    4     5
Name of home church:
Invited by:                   

   

Golden Triangle Church on the Rock ~ P.O. Box 20719 Beaumont, Texas 77720 ~ PH: 409-722-1962 ~ Email: gtcotr@cotr.com