VBS Registration
June 13th-June 17th   9 am-12 pm  
*K4 (4yrs by September 1st) - 4th grade (in coming school year)*
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Email *
PART ONE - VBS CAMPER INFORMATION
Family Last Name: *
Child One's Name *
Child One's DOB *
MM
/
DD
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YYYY
Child One's Gender *
T-Shirt Size *
Child One's Grade in the Fall *
Child Two's Name
Child Two's DOB
MM
/
DD
/
YYYY
Child Two's Gender
T-Shirt Size
Child Two's Grade in the Fall
Child Three's Name
Child Three's DOB
MM
/
DD
/
YYYY
Child Three's Gender
T-Shirt Size
Child Three's Grade in the Fall
Child Four's Name
Child Four's DOB
MM
/
DD
/
YYYY
Child Four's Gender
T-Shirt Size
Child Four's Grade in the Fall
For more children see bottom of form and fill out there.  
PART TWO: PARENT/GUARDIAN INFORMATION
PLEASE PROVIDE ALL NECESSARY INFORMATION
Parent's/Guardian's Information *
Parent's/Guardian's Street Address *
Parent's/Guardian's City & Zip Code *
Preferred Email Address: *
Contact Phone # to be used during VBS- Emergency # *
Add'l Emergency contact and #
Any Allergies or other concerns we need to know about during VBS.
Please indicate your child's name and a friend's name and the grade to be with in a group.
VBS Tuition Amounts *
Please make checks payable to OLS PSR and Mail to: 1730 Oxmoor Rd., Homewood AL 35209
To use the PayPal option, click link back on PSR page.
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