Vacation Bible School

July 8th – 12th 9:30- 12:00

Please fill out a form for each individual child

VBS Registration Form

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First Name

Last Name

Date of Birth

Age

Grade This Fall

Mailing Address

City

Zip / Post Code

Telephone Numbers

Allergies

Van A

Van B

Car Rider

Lively Stones Baptist Church

2347 Chandler Mill Road

Pelham, NC 27311

Church- (336) 939-7950

Call Lori Lee- (336) 514-5204 for van pickup information