VBS Registration
August 2-6, 2021 9am-11:30am
Daytona Beach Drive In Christian Church
3140 S. Atlantic Avenue Daytona Beach Shores, FL 32118
386-767-8761 revmelissa@driveinchurch.net
Email *
Child's Name/Grade Completed/Age (Please complete one registration/child) *
Complete mailing address (including zip code) *
Parent/Guardian Name & phone number *
Can we communicate with you via text message? *
Do we have permission to use your child's photo on our social media posts/website *
Emergency Contact Name and cell phone # *
Special Needs/Allergies we should be aware of *
Name/relationship/Cell # of person authorized to pick up your child *
A copy of your responses will be emailed to the address you provided.
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