2017 VBS - Copy
 
2017 VBS - Copy
at Calvary Chapel Finger Lakes 1777 Rochester Road Farmington, NY 585-398-3550
July 10-14, 2017
Monday 8:40 am - Noon Tuesday - Friday 9:00 am - Noon
For Ages 4-12
PLEASE COMPLETE ONE FORM FOR EACH CHILD. Thank You!
Student Name:  * 
Student Birthdate  * 
Guardian’s Name:  * 
Guardian’s Cell Phone:  * 
Emergency Contact Name:  * 
Emergency Contact Cell Phone:  * 
Who had permission to pick up this child?  * 
Medical conditions or special concerns:
Parent / Guardian Name:  * 
Parent / Guardian Address:  * 
Parent / Guardian Phone:  * 
Your Email Address  * 
 
 
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