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VBS Child Registration
VBS DATES : June 13,14,15 Time: 9am - 12pm
Address: 405 M-37, Hastings, MI 49058
Contact Church office: (269) 945-5463
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Child's Gender
*
Female
Male
Child's grade level for this next school year
*
Preschool 3-4 year olds
Kindergarten (5 & 6 Year olds) & 1st Grade
2nd & 3rd Grade
4th & 5th Grade
Jr. Leader - (Any 6th - 12th Grade student)
Other:
Parents Name
*
Your answer
Parent Phone Number
*
Your answer
Parent Email
*
Your answer
Alternate Pick up Person for Child?
Yes
No
Other:
Alternate Emergency Contact (Name & Phone Number)
*
Your answer
What days will your child attend?
*
Day 1 Tuesday, June 13th
Day 2 Wednesday, June 14th
Day 3 Thursday, June 15th
All 3 Days
Required
Medical Concerns
*
None
Yes, Please explain
Other:
Required
If yes to medical concerns, please explain here:
Your answer
Food Allergies
*
None
Yes - Please Explain
Other:
If yes to allergies, please explain here:
Your answer
Parent, are you interested in staying?
*
Yes, I would love to!
Maybe
No, Thank you
Volunteer to assist with getting the children from station to station
Kitchen help
Willing to help where ever needed!
Other:
How did you hear about our VBS?
Friend
News Paper
Social Media
Other:
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