AHOW 2022 Vacation Bible School

Agape House of Worship 2022 Vacation Bible School
For Boys and Girls Ages 3yrs – 13yrs
Date:  July 11th – July 15th 2022| Time: 6:00pm – 8:30pm | Venue: 239 E. 1st Avenue, Roselle, NJ
REGISTRATION IS FREE!!!! SPACE IS LIMITED
To register your child, please complete the form below.

Registration must be completed
Parent/Legal Guardian

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Use the space below to provide complete and accurate health information. Examples of such information are if the child has been diagnosed with: asthma, allergies, diabetes, disorders of a body organ (heart, lungs, liver), ADHD, Autism spectrum disorder, non-verbal, limited mobility, aggressive behaviors, not potty trained, intolerances, etc. or is a flight risk. This is required and necessary to provide a safe and fun environment for all children and volunteers. Type N/A if none from the above
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Use the space below to provide complete and accurate health information. Examples of such information are if the child has been diagnosed with: asthma, allergies, diabetes, disorders of a body organ (heart, lungs, liver), ADHD, Autism spectrum disorder, non-verbal, limited mobility, aggressive behaviors, not potty trained, intolerances, etc. or is a flight risk. This is required and necessary to provide a safe and fun environment for all children and volunteers. Type N/A if none from the above
MM slash DD slash YYYY
Use the space below to provide complete and accurate health information. Examples of such information are if the child has been diagnosed with: asthma, allergies, diabetes, disorders of a body organ (heart, lungs, liver), ADHD, Autism spectrum disorder, non-verbal, limited mobility, aggressive behaviors, not potty trained, intolerances, etc. or is a flight risk. This is required and necessary to provide a safe and fun environment for all children and volunteers. Type N/A if none from the above
In the event of a medical emergency and I cannot be reached, I give permission for my child to receive medical attention
I give permission for my child's picture to be used in social media communications.
This field is for validation purposes and should be left unchanged.

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