VBS Registration

Registration is $12 per child and includes all VBS activities and snacks. Payment can be made on our web site, the CCC app (ccc fresno) or brought to Central Community Church . You may also mail your payment no later than Monday, June 10th or pay at the VBS booth on Sundays. VBS is open to all Preschool (3's & 4's - if potty trained) aged children through 6th grade.

* Indicates required field

Parent Name *

First

Last

Address *

City *

State *

Zip *

Home Number *

Parent/caregiver cell number *

Email *

Home church *

Emergency Contact

Name *

First

Last

Phone Number *

Child 1

Name *

First

Last

Choose One *

M F

Age *

Last grade completed *

Date of birth *

Allergies or medical conditions *

Child 2

Name *

First

Last

Choose One *

M F

Age *

Last grade completed *

Date of birth *

Allergies or medical conditions *

Child 3

Name *

First

Last

Choose One *

M F

Age *

Last grade completed *

Date of birth *

Allergies or medical conditions *

Child 4

Name *

First

Last

Choose One *

M F

Age *

Last grade completed *

Date of birth *

Allergies or medical conditions *

Child 5

Name *

First

Last

Choose One *

M F

Age *

Last grade completed *

Date of birth *

Allergies or medical conditions *

Make Checks Payable to Central Community Church

I Will Pay *

With Check Online Cash

Is there anythig we need to Know about your child *

I agree to receiving marketing and promotional materials

Register

Pay here

$12 per child