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VBS 2014

Don't miss Vacation Bible School, July 14-18 from 8:30 a.m. to noon.

Please register each child individually. Thank you!

    • Child's Name *


    • Date of Birth *

    • Address *







    • Allergies, if any

    • School Child Attends *

    • Current Church Home


    • Mother's Name *


    • Mother's Email

    • Mother's Phone (Home)



    • Mother's Phone (Cell)



    • Mother's Phone (Work)




    • Father's Name


    • Father's Email

    • Father's Phone (Home)



    • Father's Phone (Cell)



    • Father's Phone (Work)





    • Emergency Contact (other than parent) *


    • Relationship *

    • Daytime Phone *




    • Secondary Phone





    • Physician's Name *


    • Physician's Phone *





    • VBS 2014 Release *
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    • Comments or Additional Information

NOTE: Do Not Alter These Fields:


come visit

302 West Jackson Street
RidgelandMS 39157
We would love to see you on Sunday!

get social