Rolling Oaks Christian Church Vacation Bible School Registration
Child's First Name:	*
Child's Last Name:	*
Child's Middle Name:
Child's Nickname (if different than first name):
Child's Date of Birth (please use mm/dd/yyyy):	*
Child's Age:	*
Grade Completed:	*
Address:	*
City:	*
State:	*
ZIP Code:	*
Name(s) of Parent(s) or Guardian(s):	*
Home Phone (xxx) xxx-xxxx:	*
Work Phone (xxx) xxx-xxxx:
Cell Phone (xxx) xxx-xxxx:
Emergency Phone (xxx) xxx-xxxx:	*
Email (primary):	*
Email 2:
Email 3:
Health Considerations (allergies, asthma, diabetic, etc.)
Is there a special friend (or friends) your child would like to be with?
Is there anything else that your child's Vacation Bible School teacher should know?