Wild About Jesus VBS Registration
Parents name(s) (first, last) *
Phone Number *
Do you have a home church?
Clear selection
Child 1: name and age *
Child 2: name and age
Child 3: name and age
Child 4: name and age
Child 5: name and age
Emergency contact (name, phone, relationship to child) *
Food Allergies (please list)
Medical concerns (please list)
Please list the name and phone number of anyone who has permission to pick up your child from VBS.
Photo/Video permission
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