2017 Decatur Township Community VBS
 
[Sponsored By: Decatur Township Churches]
 
Stephen Decatur Elementary School
June 12-16, 2017
5:30pm … Free Dinner
6:30-8:30pm … VBS
 
 
For More Info:
317.856.0589
 
 
Registration Form
 
Please Fill Out One Registration Form Per Child
 
NOTE: 
 
VBS is available for all children who will be attending school in 2017-18 (K-12).
 
Pre-K and nursery care are available for VBS staff only. 
 
If you are VBS staff and registering a Pre-K child, please enter “Pre-K” in the box for “Grade 2017-18” below. Your child will then be placed in the appropriate group according to their birthdate.
 

Name of Child

Gender

Birthday

Child's Grade 2017-18

Address

Address Line 2

City

State

ZIP

Parent/Guardian

Contact Phone Number

2nd Contact Phone Number

Email

Primary Language Spoken At Home

Additional Emergency Contact Name

Emergency Contact Relationship To Child

Additional Emergency Contact Phone

Name Of Home Church

Food Allergies (if any)

Medical Concerns?

Transportation Needed?
YesNo