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Family VBS Registration Form
Families with children ages 3 years thru 5th grade are invited to join us for 4 nights of worship, activity, and guaranteed memory making experiences
JUNE 10-13
from
6:00pm-7:30pm
. Registration deadline is May 15.
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* Indicates required question
Family Name
*
Your answer
Family Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Parent/Guardian 1 Attending VBS First & Last Name (at least one parent/guardian is required to participate with his/her children)
*
Your answer
Parent/Guardian 2 attending VBS First & Last Name
Your answer
Child 1: First and Last Name
*
Your answer
Child 1: Date of Birth
*
MM
/
DD
/
YYYY
Child 1: Age/2023-2024 Grade
*
Your answer
Child 1: Allergies and/or Medical Conditions
*
Your answer
Child 2: First and Last Name
Your answer
Child 2: Date of Birth
MM
/
DD
/
YYYY
Child 2: Age/2023-2024 Grade
Your answer
Child 2: Allergies and/or Medical Conditions
Your answer
Child 3: First and Last Name
Your answer
Child 3: Date of Birth
MM
/
DD
/
YYYY
Child 3: Age/2023-2024 Grade
Your answer
Child 3: Allergies and/or Medical Conditions
Your answer
Child 4: First and Last Name
Your answer
Child 4: Date of Birth
MM
/
DD
/
YYYY
Child 4: Age/2023-2024 Grade
Your answer
Child 4: Allergies and/or Medical Conditions
Your answer
Photo Consent: Throughout VBS, a photographer will take pictures and shoot footage that could be used in future Vineville Baptist print materials and/or website and social media. By
typing my name below
I give permission for the church to use my image, my children(s) image(s), and the image of anyone else I have registered.
If you do not give consent, please type NO.
*
Your answer
Childcare
Please let us know below if you also have a child (0-2 years) that you would like to register for VBS Childcare. *Childcare is only available for families with older children who are also participating in Family VBS.
Childcare 1: First and Last Name
Your answer
Childcare 1: Date of Birth
Your answer
Childcare 1: Age as of May 2024
Your answer
Childcare 1: Allergies and/or Medical Conditions
Your answer
Childcare 2: First and Last Name
Your answer
Childcare 2: Date of Birth
Your answer
Childcare 2: Age as of May 2024
Your answer
Childcare 2: Allergies and/or Medical Conditions
Your answer
DINNER RESERVATIONS
An optional dinner will be available from 5:15pm-5:50pm each evening of VBS. Please let us know if your family would like dinner during the week. The cost is $3.00/child and $5.00/youth and adult with a $20.00 family max.
Monday's Dinner Menu:
Sandwiches and Fruit
How many meals would you liked reserved for Monday? If none, please type 0.
*
Your answer
Tuesday's Dinner Menu:
Hotdogs and Chips
How many meals would you liked reserved for Tuesday? If none, please type 0.
*
Your answer
Wednesday's Dinner Menu:
Pizza
How many meals would you liked reserved for Wednesday? If none, please type 0.
*
Your answer
Thursday's Dinner Menu:
Chicken Strips and Green Beans
How many meals would you liked reserved for Thursday? If none, please type 0.
*
Your answer
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