Mt. Pleasant Church

3606 Slane Rd. Van Wert, OH 45891

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VBS Registration
June 20 - 24
8:45 - 11:30 AM
  
Please enter your First & Last Name
and E-mail address.
 
In the Message field, please list for each child:
  1. Name
  2. Address
  3. Phone
  4. Emergency Phone
  5. Age
  6. Birthday
  7. Grade in school last completed
  8. Allergies
  9. Parents names
 
* First name (required):

* Last name (required):
* E-mail address (required):

Phone number:
* Message (required):