VBS Registration Form 2018
CHILDREN AGES 4 THROUGH 5TH GRADE are eligible to participate in VBS. Please complete this form to register your child(ren) for VBS at Village Baptist Church. A separate form must be completed for each child attending. Be sure to scroll through all items and click the submit button at the bottom of the form.
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Last grade completed in school *
Choose one
Address *
Number and Street
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Email address of parent/guardian
Your answer
Name of Parent(s)/Guardian(s) *
Your answer
Emergency Contact Information *
Your answer
Relationship to child *
Your answer
First and last name(s) of person(s) authorized to pick up child from VBS *
Your answer
Primary phone number of person authorized to pick up child from VBS *
Your answer
email address of person authorized to pick up child *
Your answer
List all allergies and/or other pertinent medical information *
If none, please type "none"
Your answer
Does your child attend Village Baptist Church *
If not, please answer the next question
Name of home church
optional
Your answer
Would you like to volunteer to help with VBS?
optional
Submit
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