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VBS Registration -- Who Is My Neighbor?
Ages 4 years old to completed grade 5
Monday, June 18th to Thursday, June 20th
Dinner starts at 5:30 p.m.
Program from 6:00 p.m. to 8:00 p.m.
Email address *
Parent's Names
Your answer
Parent's Email *
Your answer
Parent's Contact Number *
Your answer
Full Address
Your answer
Emergency Contact
Your answer
Emergency Contact Phone #
Your answer
Child #1 Name *
Your answer
Child #1 Age *
Your answer
Child #1 Grade Completed in June '19 *
Child #1 Allergies or Other Concerns
Your answer
Child #2 Name
Your answer
Child #2 Age
Your answer
Child #2 Grade Completed in June '19
Child #2 Allergies or Other Concerns
Your answer
Child #3 Name
Your answer
Child #3 Age
Your answer
Child #3 Grade Completed in June '19
Child #3 Allergies or Other Concerns
Your answer
Child #4 Name
Your answer
Child #4 Age
Your answer
Child #4 Grade Completed in June '19
Child #4 Allergies or Other Concerns
Your answer
What days will you attend? Check all that apply *
Required
Dietary restrictions *
Cost is $5 per child *
Required
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