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Participant Registration

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Abundant Life Community Church

Location

7333 Sharon Rd.

Newburgh, IN 47630

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Contact Kim Forston:

812-853-3437

kforston@alccn.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Please give us your phone number OR the phone number & name of who we should call in an Emergency

Emergency Contact Phone

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Emergency Contact Name

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If someone other than yourself will be available to pick up your child, please provide that information below.

Alternate Pickup Name

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Alternate Pickup Phone

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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VBS at ALCC is for children ages 3 years (and potty trained) up through those entering 6th Grade this fall.

Gender

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Age

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Grade Entering

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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