2017 VBS Registration 2018 Summer Day Camp Registration-Under the Big Top How Many Children?*Select the number of childern123456Children's InfoFirst NameLast NameGrade in School 2017/18Shirt Size * (Specify Child or Adult) *Shirt Sizes: Child: S,M,L & Adult: ES,S,M,L | Click on the (+) symbol to add more kids. | Preschool (4 years old) - Fifth GradeMother's Name* First Last Father's Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent Phone NumberAlternative Parent Phone NumberParent Email* Please describe any medical or behavioral issues we need to be aware of (allergies, medications, behavioral issues, etc.)How did you hear about our Day Camp?*Select OneCommunity Covenant Church member/attenderFriend/Family inviteStreet AdvertisingMailerWebsiteOtherPlease place my child in a group with:Emergency Contact (other than parent) Name* First Last Emergency Contact Phone Number*Early Bird Pricing is $20.00 per kid Price: $20.00 Total $0.00 When you click "Checkout" you will be redirected to PayPal. You may then click on "pay with debit or credit card" or login to your PayPal account and pay with that. If you'd like to pay by cash or check, click "checkout" to confirm your registration and contact the church office for payment. Call us at 619-447-2675 if you have any questions or issues!