FBC Emery VBS Registration

Emergency Phone Number: *

GLORIFYING GOD BY MAKING DISCIPLES

Child 4 Grade Completed:

Child 3 Name:

(1 Corinthians 10:31, Matthew 28:19-20)

Cell Phone: *

Child 3 Age as of 5/27/25:

Child 2 Name:

Child 1 Name: *

Child 1 Grade Completed: *

Name to contact in case of emergency: *

Pickup Person Phone: *

Person Responsible for Pickup: *

Special Needs (allergies, etc.)

First Baptist Church, Emery, SD

Parent/Guardian/Grandparent Name: *

Child 4 Age as of 5/27/25:

Child 5 Grade Completed:

I'd like the VBS music *

On a CD

Link to YouTube

Child 2 Grade Completed:

Child 4 Name:

Email

Child 5 Age as of 5/27/25:

Vacation Bible School

First Baptist Church

May 27 - 30 (Tuesday - Friday)

8:30-11:25 am

Ages 4 - 8th Grade

**Age 3 if parent/grandparent

helping**

Home Phone: *

Pickup Person Relationship to Child(ren) *

Child 5 Name:

Address *

Child 3 Grade Completed:

Child 1 Age as of 5/27/25: *

Child 2 Age as of 5/27/25: