Highland VBS Registration
Please fill this form out completely for EACH of the children you'd like to register. You will also need to print and sign the waiver which you can bring with you on the first day of VBS.
Child's First Name
Your answer
Child's Last Name
Your answer
Age
Your answer
Birth Date
MM
/
DD
/
YYYY
Grade in the Fall
Allergies or Special Instructions
Your answer
Please place my child with (list friend's name)
Your answer
Parent/Guardian's First Name
Your answer
Parent/Guardian's Last Name
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Phone Number
Your answer
Email Address
Your answer
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