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