VBS 2024 | Peace Baptist Church

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PEACE BAPTIST CHURCH

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Plan Of Salvation

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(910) 791-4034

VBS 2024 Registration Form

Childs name

Male/Female

Address

Home Phone

Email

Date of birth

Last school grade completed

Parent/Guardian name

Mom’s cell #

Other Phone #

Allergies/Medical conditions

Contact Phone #

Person other than parent authorized to pick up your child

Age

Need transportation?

Home phone #

Dad’s cell #

Emergency contact

Relationship to child

Permission to upload a photograph or video of your child to social media

Parent / Guardian Signature

Todays Date

Thanks for registering. See you there!

Peace Baptist Church

preachershepard@bellsouth.net

(910) 791-4034

320 Military Cutoff Rd, Wilmington, NC 28405, USA

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