Amped VBS is June 3-7 6-9pm.  Please fill out all info that applies to you.  We look forward to ministering to your family during this exciting time!

* = required fields

Parent Name *
Parent Name
Address
Address
Child #1 Name *
Child #1 Name
Child #1 2017-18 grade *
Child #2 Name
Child #2 Name
Child #2 2017-18 grade
Child #3 Name
Child #3 Name
Child #3 2017-18 grade
Child #4 Name
Child #4 Name
Child #4 2017-18 grade
Please provide any allergy information below for any or all children you are signing up. By leaving this blank we will assume there are no allergy alerts for this child/children.
Media Release *
I hereby grant permission to the MHBC and its assigns to take photographs, videos and/or audio recordings of the children marked below for use in promotional items including but not limited to print, television, radio and web and understand that there will be no compensation for said usage