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Helping people say YES! to God and developing them
into fully devoted followers of Jesus Christ.
         
 
       
       

Vacation Bible School
"Crocodile Dock"
 Online Registration Form
( Be SURE to fill out a form for EACH child. )
(* = a required field)

 
 
~ Child Attendee Information ~

*Child's Name :
*Date of Birth :
*Grade Completed :
*Age :
*Parent / Guardian :
*Street Address :
*City, State, Zip :
*Home Phone :
*Cell Phone :
Email Address :

~ Emergency Contact Information ~

*Contact Name :
*Phone Number 1 :
Phone Number 2 :

~ Family Medical Provider Information ~

*Provider Name :
*Clinic :
*Phone Number :

~ Special Needs or Allergies ~
(Please be specific) :


~ Names of other family members attending ~
1 : 2 :
3 : 4 :


   
   
Dates : Aug. 2 - 6    
Times : 6:00 - 8:00 pm    
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
   
   
   
   
   
   
   
  Phone : (320) 356-9001
    
Office Hours
    

204 Avon Ave. North
 
Email : Secretary
Email : Senior Pastor
8:30 a.m. - 3:00 p.m. (Mon - Thurs)
8:30 a.m. - 12:00 p.m. (Fridays)
P.O. Box 248
Avon, MN 56310