Hero Central VBS Registration Form
June 19th - 23rd, 9am-12pm
For children exiting PK-3 through 6th grade
Child's First Name
Your answer
Child's Last Name
Your answer
Parent/Guardian Name
Your answer
Address
Your answer
Email Address
Your answer
Home Number
Your answer
Cell
Your answer
Work
Your answer
Date of Birth
Your answer
Age
Your answer
Last school grade COMPLETED
Home Church
Your answer
Allergies/Medical Information/Other
Your answer
Emergency Contact 1
Your answer
Emergency Contact 2
Your answer
Dismissal Information
Name and phone number of person(s) who may be permitted to pick up your children.
Your answer
Would you like to volunteer before/during Hero Central VBS?
Would you like to provide snacks for our volunteers?
Breakfast (donuts, muffins, etc.)
Chips
Fruit
Cookies
Bottled Water
Other
Monday
Tuesday
Wednesday
Thursday
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