Contact Us: 530.742.2495 | 2787 N Beale Rd | Marysville, CA  95901 

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                                            July 13th-17th from 6pm-8pm

You don't want to miss this year's Vacation Bible School

Don't miss an evening in the Land Down Under, the Great Barrier Reef,and many more!

 Snacks =Games= Stories = Songs and much more

Call (530) 742-2495 to find out more information and request a ride or complete the form below to register online. 

Please complete and submit this form to register your child for this year's Vacation Bible School.  If more than one child from your household will be attending, please submit an application for each child.

Item fields which are marked with an asterisk are mandatory

We are looking forward to a GREAT TIME!

Child's First Name:*
Last Name:*
Address:*
Apt or Space #
City:*
State:*
Zip code:*
Date of Birth:* (Format: mm/dd/yyyy)
Age (4-12):*
What Grade entering (this Fall):*
Home Phone*
Known Allergies
Special Needs
My child has permission to go home with:
Custody Issues*
Custody details:
 
I would like to request a ride:
 
Parent or Guardian:*
Parent Address:
Parent / Guardian Home Phone
Parent Work Phone
Parent Cell Phone
E-mail Address:
 
 
Home Church that you currently attend:
 
 
Emergency Contact:
Relationship to Child:
Phone
Emergency Cell:
Comments:
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What is the sum of five and eight?*
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