VACATION BIBLE CAMP Registration for One Child to Passport to Peace (Grades 1 - 5) or Early Childhood Peace Passport (Ages 4 and 5).

Parent/Guardian Name

This address will receive a confirmation email

Cell Phone

Address

Child First and Last Name

Child Date of Birth

Allergies, please list

Emergency Contact: Full Name/Cell Phone/Relationship

Other than you, who may pick up your child? Provide: Full Name/Cell Phone/Relationship

Description

Please fill out this form and click submit.