Thank you for your interest in Farm Fresh Faith, our 2019 Vacation Bible School at KABC!


JUNE 23-28, 2019

The form below is for pre-registration. There is NO COST for this registration now or on the date of the event. KABC will never share your personal information with any else.

Student's First Name

Student's Last Name

Student's Gender

Student's Birthdate

mm/dd/yy

2018-2019 School Grade Level

Street Address

City

State

Zip

Parent/Guardian Name

Home Phone

Cell Phone

Email Address

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

Home Church

Food Allergies

Medical Concerns We Should Know About