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There is no cost for attending our Vacation Bible School camp. The registration form below must be filled out for each child who would like to attend.

Fields marked with an * are required.

Child Information

Child's First Name *

Child's Last Name *

Child's Date of Birth (dd/mm/yyyy) *

Please list any foods your child is allergic to

Does your child have any physical, emotional, mental, behavioural concerns or limitations that our staff should be aware of? If yes, please explain.

Is your child bringing any medication with him/her? If yes, please list.

Authorisation and Medical Consent

Parent's First Name *

Parent's Last Name *

Address *

City *

Province *

Postal Code *

Parent's Email *

Phone *

Other Church Affiliation

Child's Health Card Number *

Emergency Contact Name and Phone Number *

Child's Family Doctor

Family Doctor's Phone Number

Who will be picking up your child each day (list all possibilities)? *

I/we, named above, agree that Lansing Gospel Hall may periodically send emails to the email identified above regarding our programs in the community.

Today's Date *

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Vacation Bible School 2019 Registration

Child Information

Authorisation and Medical Consent