LBC VBS Registration

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Please use this form to pre-register for VBS! VBS is Monday, June 27th - Friday, July 1st 7pm - 9pm. Ages are 5 - 12.

Adresă de e-mail *

First and Last Name of Child #1 *

Age Of Child #1 *

First and Last Name Of Child #2

Age Of Child #2

First and Last Name Of Child #3

Age Of Child #3

First and Last Name Child #4

Age Of Child #4

First and Last Name Of Child #5

Age Of Child #5

First and Last Name of Child #6

Age Of Child #6

Parent #1 Name *

Parent #1 Cell Phone *

Parent #1 Address *

Parent #2 or Emergency Contact Name *

Parent #2 or Emergency Contact Phone *

Parent #2 or Emergency Contact Address *

Any food allergies or medical conditions of attending? *

I give LBC permission to take photos and video of attending child(ren) for LBC social media & Dalhart Texan use. *

Yes

I give permission to these people to pick up the children listed above - Please give name and phone number.

I would like more info about Liberty Baptist Church. *

Yes

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