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Christmas VBS Registration Form
* Indicates required question
Adult's Name:
*
Your answer
Cell Phone number
Your answer
Email
*
Your answer
I am:
Registering a child/children
Registering as a volunteer
Child/children's name and age
Your answer
Which days will your child/children be joining us?
Tuesday 12/27
Wednesday 12/28
Any allergies or health issues? Please specify which child and give details as necessary. We will contact you directly if we have any questions.
Your answer
Alternate emergency contact if we can not reach you: (list at least 1 name & cell # please)
Your answer
Who else do you authorize to pick up your child/children? (list at least 1 name & cell # please)
Your answer
Please share anything else you feel we need to know or that you would like to share.
Your answer
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