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The River at Smyrna VBS Registration
The River at Smyrna's Vacation Bible School is for kids enrolled in school (K5-5th Grade).
June 17-21, 2019 - 6:30 p.m.-8:30 p.m.
596 Sam Ridley Pkwy, Smyrna, TN 37167
Contact us at (615) 459-2533 or
anchoredkidminz@gmail.com
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VBS Registration
Child's Name
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Date of Birth
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Grade Completed
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Child must be registered for Kindergarten for the upcoming 2019-2020 school year
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Preschool/K4
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1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Siblings Attending?
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Siblings Attending (Please include name, date of birth, and last grade completed)
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Contact Information
Parent/Guardian Name
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Address
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City
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State
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Zipcode
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Phone
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Email
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Emergency Contact Information
Emergency Contact Name
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Emergency Contact Phone
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Allergies/Other Concerns
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Authorized Pick Up Persons
Please list the name and telephone number of the individuals who are permitted to pick your child up from VBS. If someone different will be picking up your child from VBS, please have written proof from their parent/guardian to show when checking your children out. Safety is our number one priority! Thank you for understanding.
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