Vacation Bible School 2023

Grassfield Baptist Church

July 23-28

Free Dinner for Attendees: 5:30 PM

VBS Activities: 6:00 - 8:00 PM

1772 Cedar Road

Chesapeake VA 23323

For More Information:

757-547-8385

grassfieldbaptist.com

Registration From

Child’s name:                                                           

Parent/guardian’s name:                                          

Parent/guardian’s phone:                                         

Address:                                                           

Child’s birth date:                               

Last grade completed:                       

List important medical information, including food allergies:

List people who are permitted to pick up the child from VBS:

List an emergency contact if the parent/guardian cannot be reached:

Name:                                                  

Phone:                                                 

May we photograph the attendee? 

Yes  No

May we use the photograph on the church website & outreach materials?

Yes  No