ViennaKids Week Child Registration- July 7-10, 2024

Please fill out this form and click submit. You will need one for each child.

Thank you so much for your interest in ViennaKids Week! Please fill out a seperate form for each child you wish to register.

Also, please note that the dates and times have been expanded and are Sunday evening July 7th - Wednesday July 10th, from 6:00-8:30 PM.

If you have any questions, feel free to call Chasity at (336) 409-8958.

Child's Name

*

Birthday

*

Gender

*

Please select all that apply.

Male Girl

Age: (Must be Potty-Trained)

*

Please select all that apply.

4 5 6 7 8 9 10 11 12

T - Shirt? - $12

*

Please select one option.

We don't need one thank you! Youth - S Youth - M Youth - L Adult - S Adult - M Adult --L

Parent's Name (emergency contact)

*

Parent's Cell (emergency contact)

*

Second Phone

*

Address

*

Parent's Email

*

This address will receive a confirmation email

Permission Statement

By typing my name below, I give my permission for my child (named above) to attend this event (listed above) with the ViennaKids Ministry of Vienna Baptist Church; including all activities associated with the event (for example: field games, snacks, Bible time, etc.)

Parent's name (in lieu of Signature)

*

Description

Please fill out this form and click submit. You will need one for each child.

Please Fix the Following

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