VBS Registration Form
Child's First and Last Name *
Parent/Guardian Name *
Address *
Mailing Address (if different)
Contact Information: best phone number to reach you *
Contact information: email address
Child's birth date *
MM
/
DD
/
YYYY
Last grade completed in school
Medical information we need to know: (Please include any allergies)
Emergency Contacts (other than already listed): Please include name and number *
Dismissal information: Who may pick up your child at the end of each VBS day? *
Does your child attend a church? If so, where?
May we have permission to photograph your child? *
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