The church the child regularly attends (if none, write none)
Your answer
Grade Entering in Fall *
Select the grade the child will be in this fall (if not beginning school yet, mark Pre-K)
Choose
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Parent/Guardian Information
Parent/Guardian First Name *
First name of the parent or guardian of the child
Your answer
Parent/Guardian Last Name *
Last name of the parent or guardian of the child
Your answer
Parent/Guardian E-mail
E-mail address at which you can be reached
Your answer
Parent/Guardian Phone Number
The phone number at which you can be reached
Your answer
Emergency/Health Information
Emergency Contact *
Person we can contact in the event of an emergency during the week of VBS (during the hours of 9am-noon)
Your answer
Emergency Contact's Relation *
The relationship of the emergency contact to the child (parent, grandparent, friend, etc.)
Your answer
Emergency Contact Phone # *
Number at which we can reach the emergency contact during VBS
Your answer
Allergies/Special Needs
Please list any allergies or special needs for which we may need to account
Your answer
We are offering to provide lunches for children who might need them. Would you like us to provide your child with a free sack lunch after VBS each day?
Clear selection
Walk/Ride Permission
My Child has permission to walk/ride their bike home from VBS
Other Information
Any other information you think might be helpful for us to have