PLEASE COMPLETE ONE REGISTRATION CARD FOR EACH CHILD.

Asbury's VBS Registration Card
 
Child's First Name:
 *
Child's Last Name:
 *
Address:
 *
City:
 *
State:
 *
Zip Code:
 *
Home Phone:
 *
Cell Phone:
 *
(None if not applicable)
Birth Date:
 *
Gender:
Female
Male
Grade in Fall:
 *
School Attending (if any):
 *
(None if not applicable)
Parent or Guardian:
 *
Email Address:
 *
Work Phone:
 *
Home Church (if any):
 *
(None if not applicable)
Allergies:
 *
(None if not applicable)
Medications:
 *
(None if not applicable)
Special Needs:
 *
(None if not applicable)
Emergency Contact Name:
 *
Emergency Contact Phone:
 *
 
To Pre-order T-shirts @ $11.00 each:
Childrens Shirts Wanted
 *
None
Child small (6-8)
Medium (10-12)
Large (14-16)
Adult Shirts Wanted
 *
None
Small
Medium
Large
X-large
To Pay for the T-shirts you can send your check to the church Attn: Beth Gray-VBS or pay for them on arrival.
 
By registering I give permission to use photos of my child to support Asbury Children's Ministries
 
How did you find out about VBS at Asbury?
Church Member
Church Visitor
Church Sign
"Mom's Directory"
Friend
School Summer Fair
Other
 
Comments:
 *
(none if not applicable)
 
 
Security code:
 *
* indicates a required field

 

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Asbury Church - Purpose Driven by the Lord!

7501 South Staples
Corpus Christi, TX 78413
Ph. 361/992-7501
Fx. 361/992-1688
Beth's email: truly@jesusanswers.com

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