VBS Registration 2018

* Indicates required field

Child's Name *

First

Last

Parent's Name *

Email *

Address *

Phone *

Name of Emergency Contact other than parent *

First

Last

Emergency Contact Phone Number *

Preschool VBS is open to all 3yr olds -5yr olds

Preschooler's Birth Date *

Elementary VBS Is open to all boys & girls who have completed K-5th

Grade Recently Completed *

Medical Information *

Allergies *

PIN (PERSONAL INDENTIFICATON NUMBER ) *

Please list who has permission to pick up your child each night *

Do we have permission to photograph your child for the purposes of promoting VBS on our church website *

Submit