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Shiloh VBS Registration 2018
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Grade Next Year *
(2017-2018)
T-Shirt Size *
Emergency Contact *
Your answer
Phone Number *
Your answer
Alternate Emergency Contact
First Name
Your answer
Last Name
Your answer
Phone Number
Your answer
Allergies/Medical Conditions/Behavioral Issues/Other Concerns None *
Please write "none" if not applicable.
Your answer
If you would like to help at VBS
Do you give us permission to use pictures your child may be in on social media or for internal church use? *
$5.00 per child / $10.00 family maximum
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