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VBS Registration Form (One per child)
Registration for Vacation Bible School, August 8th-12th from 6:00-8:00PM.
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* Indicates required question
Child's name
*
Your answer
Child's Gender
*
Male
Female
Child's age
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Last school grade completed
*
Your answer
Name of parent(s):
*
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Home Telephone
Your answer
Parent/caregiver's cellphone
*
Your answer
Home email address
*
Your answer
Home church
Your answer
Allergies or other medical conditions
*
Your answer
In case of emergency, contact:
*
Your answer
Phone
*
Your answer
Relationship to child:
*
Your answer
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