VBS Registration


Child Information

Child's Name (First & Last)

Birthday (MM/DD/YYYY)

Grade (Last Completed)

Medical Information (Include food allergies)

Parent Information

Parent Name (First & Last)

Address

City

State

Zip

Mailing Address (If Different from Address)

City

State

Zip

Home Phone

Work Phone

Cell Phone

Email

Emergency Contacts

Name (First & Last)

Phone Number

Name (First & Last)

Phone Number

Dismissal Information

Who may pick up your child at the end of each VBS day?

Other Information

Does your child attend Sunday School? If yes, where?

If your child is visiting our church, who is he/she a guest of?

May we have permission to photograph your child?

May we have permission to use your child's photograph for the purpose of promotion?