victory christian fellowship international church

	victory christian fellowship international church
	Taking the Gospel of Christ to a New Generation

YouthCampRegistration
Todays Date: Mth/Day/Year (00/00/0000)

Home Phone: *

Cell Phone:

Emergency Phone: *

Name two people to contact in case of emergency: *

Email address: *

Address 1: *

Address 2:

City: *

State: *

Postal Code: *

Parents Name(s): *

First Sudents Name: *

First Students Allergies: *

First Students Physical Limitations:

First Students Age: *

First Student TShirt Size: *

Boy or Girl: *

Second Students Name:

Second Students Allergies:

Second Students Physical Limitations:

Second Students Age:

Second Student TShirt Size:

Boy or Girl:

By stating TRUE on this form, I understand that I am committing to concurrance with and agreement to the VCFI Hold Harmless Policy and Rules of Participation. *

Name of Person submitting form: *

Age of Person submitting form: *

Are you the Parent or Legal Guardian of all the above students? *

Total Amount Due:

I will mail a check for the total amount: (YES or NO)

I will return to the event page and use the PayPal option: (YES or NO)

I will provide my Credit Card information on this form (Non-Secure): Provide Full name on Card, Card Number, Expiration Date, and CVS Security Number (3 digits on back of Card)


* Required fields