REGISTRATION
Monday June 11th - Friday June 15th, 6:00 PM - 8:00 PM.
Email address *
Child's Name *
Your answer
Parent / Guardian Name *
Your answer
Address *
street address
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mailing Address
If different
Your answer
Phone Number *
Best number to reach you during VBS
Your answer
Child's Birth Date *
Your answer
Last grade completed in school *
Your answer
Medical Information
Information we need to know (Please include any food allergies)
Your answer
Emergency Contact Name *
(other than listed above)
Your answer
Emergency Contact Number
(other than listed above)
Your answer
Dismissal Information *
Who may pick up your child at the end of each VBS day?
Your answer
Church Information
If your child is visiting from another church, who is he a guest of?
Your answer
May we have permission to use your child's photograph for the purpose of promotion? *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms