VBS Hawaii 2023 - Registration + Waiver Form

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Welcome to VBS 2023. Register and complete all the forms below.

VBS 2023 is a cooperative work of Hawaii Christian Baptist Church, Mililani Fil-Am Baptist Church, Waipahu Community Christian Church, and Word of Truth

FILL OUT ONE PER ATTENDEE. Please do not combine multiple attendee names in one form. Mahalo.

FIRST NAME *

LAST NAME *

GRADE LEVEL from SY 2021-2022 *

Nursery

Preschool

Kindergarten

Yang lain:

SHIRT SIZE *

Youth - XS

Youth - S

Youth - M

Youth - L

Youth - XL

Adult - XS

Adult - S

Adult - M

Adult - L

Adult - XL

Adult - 2XL

Yang lain:

STREET ADDRESS (include apartment or unit number)

CITY

ZIP CODE

PARENT or GUARDIAN'S NAME (put "SELF" if not a minor) *

RELATIONSHIP (mother, father, grandparent, etc.) *

BEST CONTACT NUMBER *

EMERGENCY CONTACT *

EMERGENCY CONTACT RELATIONSHIP (mother, father, grandparent, etc.) *

EMERGENCY CONTACT NUMBER *

FOOD, DRUG, AND OTHER ALLERGIES *

CURRENT MEDICATIONS TAKING

LIST OTHER ALL PERTINENT MEDICAL ISSUES

PRIMARY CARE PHYSICIAN'S NAME

PRIMARY CARE PHYSICIAN'S CONTACT NUMBER

Berikutnya

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