VBS 2019 Participant Registration
We are currently at capacity. If you register after May 23rd you will be added to the waitlist and notified if a spot becomes available.
June 24-28, 9am-2:30pm (before and after care available 7-9am and 2:30-5:30pm)
Child's First Name *
Your answer
Child Last Name *
Your answer
Child's Birthdate *
MM
/
DD
/
YYYY
Grade just Completed *
Street Address *
Your answer
City *
Your answer
Zip *
Your answer
Parent Names *
Your answer
Home Phone Number
Your answer
Cell Phone Number *
Your answer
Email Address *
Your answer
Emergency Contact *
Your answer
Emergency Contact Phone Number *
Your answer
Before Care Needed (7am-9am) *
After Care Needed (3pm-5:30pm) *
Allergies
Your answer
Health Concerns
Your answer
Any medications taken during VBS day? *
If so, what are they
Your answer
Is there someone you'd like have in the same crew?
Your answer
Is there anyone else you'd like to have in the same large group?
Your answer
Any other information you'd like us to know?
Your answer
T-Shirt Size *
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