Mount Moriah VBS Registration
VBS July 8-12, 2019 at Mount Moriah Baptist Church, Raleigh/Garner/Clayton, NC
Please note that due to staff limitations, children must be potty trained to attend. If your child has not yet reached this milestone, we'll look forward to seeing him or her next year!
Family information
First, let's start by getting some information about the family, so we can send you info about dropping off and picking up your children, and contact you in the event of an emergency.
Custodial Parent(s) or Guardian(s) Name(s) *
The person or people responsible for the child or children during VBS.
Your answer
Primary E-mail address for the family. *
The most-used E-mail address for someone listed in the previous question. We send out VBS-related E-mail you'll need, and a wrap-up E-mail when VBS is over. Then we destroy the list.
Your answer
Street Address *
The family's address, based on the custodian listed in the first question.
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
First contact's name *
The name of one of the people listed in the first question, please.
Your answer
First contact's number *
A number where we can reach that person, in an emergency.
Your answer
First contact's back-up number
This one's optional, just in case you want to give a second number to try for that first contact.
Your answer
Second contact's name *
Just in case we can't reach the first contact, in an emergency. If you're the first contact, and you're helping at VBS, this would be someone we can call if something happens to YOU.
Your answer
Second contact's number *
A number where we can best reach that second person, in an emergency.
Your answer
Second contact's back-up number
This one's optional, just in case you want to give a second number to try for that second contact.
Your answer
Third contact's name
This one's optional, just in case you want to give us additional emergency contacts.
Your answer
Third contact's number
A number where we can best reach that third person, in an emergency.
Your answer
Third contact's back-up number
This one's optional, just in case you want to give a second number to try for that third contact.
Your answer
Fourth contact's name
Totally optional...
Your answer
Fourth contact's number
A number where we can best reach that fourth person, in an emergency.
Your answer
Fourth contact's back-up number
Just in case you want to give a second number to try for that fourth contact.
Your answer
What is the name of your home church? *
(If Mount Moriah is your home church, please type MMBC. Unfortunately the VBS registrar does not know all the Mount Moriah children.)
Your answer
If Mount Moriah is not your home church, whom should we thank for inviting you?
Your answer
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