Registration for Kids in K-6th
Thanks for taking your time to register for our VBS! We pray your kids will have fun.
Vacation Bible School
"IN THE WILD" - AMAZING ENCOUNTERS WITH JESUS - JOHN 20:31
Dates
Monday through Friday, July 22-26, 6:15-8:30 pm
Location
Grace Bible Chapel
420 Allegan Circle
San Jose, CA 95123
Contact Information
Parent's Name *
Please type the full name.
Your answer
Email Address *
Please make sure the email address is valid and accurate.
Your answer
Home Address *
Please enter your mailing address. For Example - 420 Allegan Circle, San Jose, CA 95123
Your answer
Phone Number *
Please make sure the phone number is correct. It will be printed on your child's name tag as the emergency contact number. For Example - 408-123-4567
Your answer
Children's Information
Our VBS is for children who are entering Kindergarten up through those who are entering 6th Grade. If you're registering more than 5 children, you'll have to start another form after the 5th child.
Child #1 - Name, Birthdate, Grade *
Please make sure to enter the child's first and last name, birthdate, and grade, placing commas in between. For Example - John Doe, 2/15/12, 1st
Your answer
Child #2 - Name, Birthdate, Grade
Your answer
Child #3 - Name, Birthdate, Grade
Your answer
Child #4 - Name, Birthdate, Grade
Your answer
Child #5 - Name, Birthdate, Grade
Your answer
T-Shirt Sizes
We'll be providing t-shirts to each child registered. Please write the child's name and t-shirt size below. The available sizes are Youth-Small (YS), Youth Medium (YM), Youth-Large (YL), Adult-Small (AS), Adult-Medium (AM), or Adult-Large (AL). For example - John Doe, YM
Child's T-Shirt Size *
Your answer
Food Allergies
There will be a snack served during the evening. If your child has any food allergies, please indicate the child's name and allergies below. For Example - John Doe, Peanuts
Child's Name, Allergy
Your answer
Special Requests
Each child may request to be grouped with 1 friend of similar age/grade. We will do our best to accommodate all requests, but there are no guarantees. For Example - John Doe, Joe Deer
Child's Name, Friend's Name
Your answer
Special Considerations
Please indicate if there are special considerations we should be aware of for your children. For Example - John Doe, anxious in new situations
Child's Name, Special Consideration
Your answer
Extras
These are a few extra questions we'd like you to answer to help us know more about you.
Do you attend a church? *
What church do you attend?
Your answer
How did you hear about us? *
May we send you email about our upcoming events? *
Confirmation
I UNDERSTAND THAT REGISTRATION IS NOT COMPLETE UNTIL I RECEIVE A CONFIRMATION EMAIL. A CONFIRMATION EMAIL WILL BE SENT WITHIN ONE WEEK OF RECEIVING THIS FORM. IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL AFTER ONE WEEK, PLEASE CALL KRISTEN KOPPEL AT (408) 874-5259.

** Other forms such as a medical release will also need to be signed on your first day of VBS, July 22-26.

Do you understand the confirmation? *
Required
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