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VBS Registration Form
Tuesday, July 4th to Friday, July 7th, 2023
9 am to 12 noon
Children aged 5 to 12 years old.
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Email
*
Your email
Child's Name
*
Your answer
Parent/Guardian Name
*
Your answer
Mailing Address
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
*
Your answer
Work Phone Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Home Church (if any)
*
Your answer
Friends or family of your child at this church
*
Your answer
Allergies/Dietary Restrictions/Medical Information
*
Your answer
Is an Epipen required
*
Yes
No
Required
Special needs/Anything else we should know about your child
*
Your answer
Emergency Contacts (name and phone number)
*
Your answer
Dismissal Information - Name of person(s) who have permission to pick this child up from VBS
*
Your answer
Photos from VBS are shared on the St. Andrew's Presbyterian Church social media, digital and hardcopy communications. Please authorize your permission by checking the boxes below.
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