Vacation Bible School Registration Form 2019
VBS is June 3-7 from 9:00am - Noon.

Please complete the following form in order to register your child for VBS at Shades Crest Baptist Church. When you have completed all the information please click the SUBMIT button.

In The Wild
PARENT INFORMATION
Please complete the following information.
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Contact Number *
Your answer
Street Address *
Your answer
City, State, and Zip *
Your answer
Primary Email Address for the Family *
Your answer
Secondary Contact Person
Your answer
Secondary Contact's Cell
Your answer
EMERGENCY CONTACT INFORMATION
Name (First and Last) *
Your answer
Relationship *
Your answer
Cell Number *
Your answer
PARTICIPANT INFORMATION
Please complete the following information for each child you wish to register for VBS.
Child #1
Please complete the following information for the 1st child you are registering.
First Name *
Your answer
Last Name *
Your answer
Gender *
Grade completed as of May 2019 *
Birthday *
mm/dd/year
Your answer
Does your child have a friend in the same grade they would like to be with during VBS?
We will do our best to honor these requests but we cannot guarantee that all requests can be met.
Your answer
Does your child have any allergies or special conditions that we need to know about? *
If no conditions exist please respond with NA
Your answer
Child #2
Please complete the following information on the 2nd child you are wishing to register.
First Name
Your answer
Last Name
Your answer
Gender
Grade completed as of May 2019
Birthday
mm/dd/year
Your answer
Does your child have a friend in the same grade they would like to be with during VBS?
We will do our best to honor these requests but we cannot guarantee that all requests can be met.
Your answer
Does your child have any allergies or special conditions that we need to know about?
If no conditions exist please respond with NA
Your answer
Child #3
Please complete the following information on the 3rd child you are wishing to register.
First Name
Your answer
Last Name
Your answer
Gender
Grade completed as of May 2019
Birthday
mm/dd/year
Your answer
Does your child have a friend in the same grade they would like to be with during VBS?
We will do our best to honor these requests but we cannot guarantee that all requests can be met.
Your answer
Does your child have any allergies or special conditions that we need to know about?
If no conditions exist please respond with NA
Your answer
Child #4
Please complete the following information on the 4th child you are wishing to register.
First Name
Your answer
Last Name
Your answer
Gender
Grade completed as of May 2019
Birthday
mm/dd/year
Your answer
Does your child have a friend in the same grade they would like to be with during VBS?
We will do our best to honor these requests but we cannot guarantee that all requests can be met.
Your answer
Does your child have any allergies or special conditions that we need to know about?
If no conditions exist please respond with NA
Your answer
FAMILY FUN NIGHT
On the Wednesday night of VBS there will be a Family Fun Night. Families are invited to come and see all the children are learning in VBS, as well as enjoy an evening of fun and fellowship. Family Night will be Wednesday, June 5 from 5:00--7:00 pm. Dinner will be available for purchase.
How many in your family are planning on attending Family Fun Night, Wednesday, June 5 from 5-7pm?
Your answer
CARPOOL
Please indicate if your family will be using the carpool system to pick up your child/children after VBS each day. *
If your child or children are carpooling with another family please let us know who they will be riding with.
Your answer
If you are not planning to participate in carpool, please indicate how you plan for your children to be picked up.
Your answer
Pictures
I hereby grant permission for my child's photo to be taken and shared through the Shades Crest website and social media sites for the purpose of sharing about Vacation Bible School and future church events for children. *
Required
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