VBS 2022 Registration Form
Please register each child separately by filling out a new form for each child in your care attending.  

Doors Open at 8:50am and Pickup is at 12pm (noon).
We ask that you please bring your child into the church and sign them in each day.

Note* Pictures are occasionally taken for church records and internal documents, but will not be posted on social media or online in any official capacity by the church.
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Name of Child *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Grade *
Address *
Parent or Guardian Name *
Home Phone *
Cell Phone *
Email *
Emergency Contact  (Name and Phone) *
May your child have a snack? *
Please list any allergies your child has. *
Please list and medical concerns your child has. *
Who can pick up your child from the program? *
List any family or friends with you at church *
List any special or further instructions *
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