St. Stephen's VBS Registration Form
The FREE 2020 VBS program will be held July 13-17, Mon-Fri, 9:00am-12:00pm, for children ages 4-12. Please complete a form for each child you are registering. REGISTRATION DEADLINE - JULY 5.
Email address *
Today's Date *
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Child's Full Name *
Your answer
Birthdate *
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Last Grade Completed *
Child will attend on the following days: *
Please check off all that apply.
Required
Allergies/Medical Conditions *
Please write "none" if your child has no allergies or medical conditions.
Your answer
Parent/Guardian's Full Name *
Your answer
Contact Phone *
Your answer
Child may be released to - name & phone *
Your answer
Emergency Contact - name & phone *
Your answer
Media Release *
Photographs and/or video in which my child appears can be used by the church in printed and/or electronic media, including the church's website and Facebook page.
Submit
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