JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
VBS registration
Event Timing: Monday, June 22nd to Thursday, June 25th from 9:00-11:15 AM
Event Address: 613 18th Ave. Holdrege, NE 68949
Contact us at: (308) 995-6588
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Child's Name (First and Last)
*
Your answer
Parent's Name (First and Last)
*
Your answer
Parent's Phone Number
*
Your answer
Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Emergency Contact Name/Number
*
Your answer
Child's Gender
*
Female
Male
Child's Birthday
*
Your answer
Grade Completed (as of May 2020)
*
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th (Service Project)
8th (Service Project)
Required
Any allergies/medications we should know about?
Your answer
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms