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VBS Summer Camp 2023
Registration Form
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* Indicates required question
Child's name
*
Your answer
Child's age
*
Your answer
Child's Date of Birth:
*
MM
/
DD
/
YYYY
Child's Gender:
*
Male
Female
Other:
Last School Grade Completed:
*
Your answer
Name(s) Of Parent(s)
*
Your answer
Parent(s) Email Address
*
Your answer
Parent(s) Contact Number(s)
*
Your answer
Address: (City, Province, Postal Code)
*
Your answer
Home Church (Leave Blank If You Do Not Have A Home Church)
Your answer
Health Card Number
*
Your answer
Emergency Conatct Name and Phone Number
*
Your answer
Relationship To Child
*
Your answer
Allergies Or Other Medical Conditions (Example: Diabetes, ADHD, Anxiety, etc)
*
Your answer
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