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                                            VBS 2022 Online Child Registration Form
                                       Dates: June 5th - 8th

​                                            A registration form is required to be completed for every child under the age of 18.
​                                     Please submit your answers the questions below into the "Comment" box by June 1st.

1. Student's Name
​2. Current age
​3. Date of birth
​4. Allergies/Medical conditions
​5. Parent/Guardian name
6. Address (with city and zip code)
​7. Phone number
​8. Emergency contact name, number & relation to child
9. Home church
10. Person other than parent authorized to pick up your child
​11. Riding the church bus (Yes or No)
​12. Permission to upload a photograph or video of your child to social media (Yes or No)


    Please put the parent/guardian name and email below.
    On the "Comment", answer the questions listed above in numerical order.

    1. Student's Name ​2. Current age ​3. Date of birth ​4. Allergies/Medical conditions ​5. Parent/Guardian name 6. Address (with city and zip code) ​7. Phone number ​8. Emergency contact name, number & relation to child 9. Home church 10. Person other than parent authorized to pick up your child ​11. Riding the church bus (Yes or No) ​12. Permission to upload a photograph or video of your child to social media (Yes or No)
Submit

Pastor:
Dr. Jack Roberts
(502) 262-9751









Outreach Pastor:
Bro. Josh Smith

(502)338-1195








           Deacons:
Troy Chester       502-641-7409     
Roy Grissom        502-964-2353    

Shawn Nalley       502-724-6601     
Tony Smith           502-762-7356     
John Walls           502-376-1616
Paul Bertram, Jr. 502-762-3977
Chris Humphrey   502-718-8334
Chad O'Brien          502-544-7016
John Evans             502-599-4017   

 Church Services 
Sunday School  -  10 AM
Sunday Morning Worship -  11 AM
Sunday Evening Worship    -     6 PM
Wed. Night Adult Bible Study  -  7 PM
Wed. Night Children & Youth   -    7 PM
(Services Interpreted for the Deaf)