LSC VBS Registration
To register for the FREE Vacation Bible School at LifeSpring Church please fill out this form.
Please note: VBS is for completed K-5th Grade children only.
Submission of this form gives permission for pictures of your child to be taken during the week of VBS.
Child's First & Last Name *
Your answer
Gender *
Last COMPLETED School Grade
Date of Birth *
MM
/
DD
/
YYYY
Child's Street Address *
Your answer
City, St, Zip Code *
Your answer
Mother/Guardian's Name (that lives with the child)
Your answer
Mother/Guardian's Work Phone Number
Your answer
Mother/Guardian's Cell Phone Number
Your answer
May we text Mother's/Guardian's Cell Phone Number?
Mother/Guardian's Email
Your answer
Father/Guardian's Name (that lives with the child)
Your answer
Father/Guardian's Work Phone Number
Your answer
Father/Guardian's Cell Phone Number
Your answer
May we text Father's/Guardian's Cell Phone Number?
Father/Guardian's Email
Your answer
Emergency Contact Between 8:25am and Noon (first and last name) *
Your answer
Emergency Contact Phone Number *
Your answer
Allergy, Medical, or Special Needs Information
Your answer
Who, besides parents/guardians listed above, are we able to release your child to? (Must be at least 16 years of age.) These names will appear on security badge until we are notified differently. Please include names for any possible pick up (babysitter, friend, non-custodial parent, grandparents, neighbor, etc.) It is possible we will check ID. *
Your answer
How did you learn about our VBS? *
Required
Guest/Friend of...
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of LifeSpring Church. Report Abuse