Christmas in June VBS Registration
Please complete one form per child. You will receive a confirmation email of your child's registration in 3 business days.
Child's First Name *
Child's Last Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Allergies (if none, please type NONE) *
Medical Concerns (if none, please type NONE) *
Parent's First Name *
Parent's Last Name *
Phone Number *
Email Address *
Street Address *
City *
Zip Code *
Emergency Contact's Name *
Emergency Contact's Phone Number *
Emergency Contact's Relationship to child *
Alternate Pickup Person's Name *
Alternate Pickup Person's Phone Number *
Home Church Affiliation (if none, please type NONE) *
How did you hear about our VBS? *
Required
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