Sunday Services at 9:00 and 10:45am
95-1080 Ukuwai Street; Mililani Mauka, HI
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Vacation Bible School Registration Form
CHILDREN'S INFORMATION:
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Child 1: Name
*
First
Last
Child 1: Allergies
*
Child 1: Last Grade Completed
*
Pre-K (age 4-5)
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Child 2: Name
*
First
Last
Child 2: Allergies
*
Child 2: Last Grade Completed
*
Pre-K (age 4-5)
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Child 3: Name
*
First
Last
Child 3: Allergies
*
Child 3: Last Grade Completed
*
Pre-K (age 4-5)
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Child 4: Name
*
First
Last
Child 4: Allergies
*
Child 4: Last Grade Completed
*
Pre-K (age 4-5)
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
PARENT/GUARDIAN INFORMATION:
Father/Guardian Name:
*
First
Last
Phone Number:
*
Address (If different from child):
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Is Father/Guardian a member of a church?
*
Yes
No
If yes, name of church:
*
Mother/Guardian Name:
*
First
Last
Phone Number
*
Address (If different from child):
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Is Mother/Guardian a member of a church?
*
Yes
No
If yes, name of church:
*
Who will drop off and pick up your children?
*
Cornerstone Fellowship has permission to use my child(ren)'s photo/video for church purposes:
*
Yes
No
Would you be interested in staying during VBS to learn about what the children are learning (Bible stories)?
*
Yes
No
Additional Information/Comments:
*
Submit
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