Please include the information below for each child in the same family that are ages 4 through entering 6th grade in the fall and plan to attend VBS.
First Child's Name *
Your answer
First Child's Age *
Your answer
First Child's Grade This Fall *
Please list any allergies or special concerns for this child.
Your answer
Second Child's Name
Your answer
Second Child's Age
Your answer
Second Child's Grade This Fall
Clear selection
Please list any allergies or special concerns for this child.
Your answer
Third Child's Name
Your answer
Third Child's Age
Your answer
Third Child's Grade This Fall
Clear selection
Please list any allergies or special concerns for this child.
Your answer
Fourth Child's Name
Your answer
Fourth Child's Age
Your answer
Fourth Child's Grade This Fall
Clear selection
Please list any allergies or special concerns for this child.
Your answer
First Parent/Guardian Name *
Your answer
First Parent/Guardian Address *
Your answer
First Parent/Guardian Phone Number *
Your answer
First Parent/Guardian Email *
Your answer
Second Parent/Guardian Name
Your answer
Second Parent/Guardian Address (if different)
Your answer
Second Parent/Guardian Phone Number
Your answer
Second Parent/Guardian Email
Your answer
Would you be interested in helping out during VBS? If so, our volunteer coordinator will give you a call to see how you can help.
Clear selection
Emergency contact name and phone number and relationship to child *
Your answer
Please list all adults who are permitted to pick your child up from VBS. *
Your answer
Please list if there is a friend your child would like to be grouped with. We cannot guarantee they will be placed together but will do our best to accommodate any requests.
Your answer
How did you hear about NHCBC's VBS?
Clear selection
Do you agree to allow photos of your child to be used in church presentation or church promotional materials? *
A copy of your responses will be emailed to the address you provided.