EmailMe Form - ERBC ZOOMERANG VBS 2022

Child's Name *
First Last
Grade Completed *
Child's Birthdate *
MM / DD / YYYY
Children must be 3 years old by May 31, 2022 in order to participate in VBS
Children get a FREE t-shirt! Please select a size for your child (sizes available are YS, YM, YL, AS, AM, AL, AXL) *
Parent's Name *
First Last
Parent's Email *
Address *

Street Address City State / Province / Region Postal / Zip Code
Emergency Contact while at VBS *
First Last
Emergency Contact Phone *
### - ### - ####
We will provide a light meal and we will be making edible dessert crafts each night. Please provide details if your child has any allergies/medical conditions we should know about: *
Name of Church Home *