2022 VBS Registration

Last Name *

First Name *

Address *

Phone # *

Parent / Guardian Name *

Emergency Contact Phone #

Child's Age *

Child's gender

Male

Female

Clear selection

I was invited by

My home church is

Photo and Liability Release Acknowledgement

By submitting this application I acknowledge and give my permission to photograph my child and use his or her picture solely for the church’s social media, and acknowledge that my child is attending this event at his or her own risk.