Honeoye Falls 2017 Ecumenical Vacation Bible Camp

* 1. What is your first and last name?

* 2. What is your child's first and last name?

* 3. Does your child have a nickname?

* 4. What is your street address?

* 5. What is the best phone number to reach you?

* 6. Please provide an emergency contact person and phone number.

* 7. What is your child's age?

* 8. What grade will your child be entering in the fall?

* 9. Do you child have any allergies or dietary restrictions? If so, please specify.

* 10. Which church do you attend?