VBS Registration | Love Fellowship

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Connect | Grow | Serve | Share

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First name*

Last name*

Email*

Phone*

e.g. 1 xxx xxx xxxx

Will you attend both evenings?*

Yes

No

Are you 18 yrs or older?*

Yes

No

Emergency Contact's Name and Number (if different than parent/guardian)

Doctor's Name and Number

List any known allergies or special needs

List other relatives attending VBS

PHONE: 786-955-6475

2245 W Bunche Park Drive,

Miami Gardens, FL 33054

Thanks for submitting!

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