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2019 VBS Registration
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* Indicates required question
Child's Name
*
Your answer
Child's Birth Date
*
Ages allowed at this years VBS (Preschool age up to 6th grade)
Your answer
School grade they completed Spring 2018
*
Your answer
Name of the school your child attended last year
Your answer
Does the child listed on this registration have other siblings attending VBS?
Yes
No
Clear selection
If you stated 'Yes' above, please state their names below and fill out a seperate registration form for each child attending. Thank you!
Your answer
Address
*
Your answer
Home Phone
Your answer
Cell Phone
*
Your answer
Email Address
*
Your answer
Parents/Gaurdians Name(s)
*
Your answer
In Case of Emergency, who should we contact
*
Please provide a full name, and a phone number they can be reached at.
Your answer
Please list all allergies and/or other medical conditions your child may have
Your answer
Does your child plan to participate in the meal available at 5:30 - 6:00 p.m.?
Yes
No
Unsure
Clear selection
What size of t-shirt does your child wear?
child small, medium, large or adult small, medium, large, extra-large
Your answer
Name of your home church, if any.
Your answer
I hereby
the church permission to use pictures of my child for promotional purposes
Grant
Do Not Grant
Parents Name (print name)
Approval of submission of the form
Your answer
Submit
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