Vacation Bible School
Register online today!

Use the form below to register your child(ren) for VBS!
Parent/Guardian's name: *
Your answer
Email address: *
Your answer
Street address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip code: *
Your answer
Child(ren) Information
First child's name: *
Your answer
First child's age: *
Your answer
Grade just completed in school: *
Your answer
Second child's name:
Your answer
Second child's age:
Your answer
Grade just completed in school:
Your answer
Third child's name:
Your answer
Third child's age:
Your answer
Grade just completed in school:
Your answer
Fourth child's name:
Your answer
Fourth child's age:
Your answer
Grade just completed in school:
Your answer
Fifth child's name:
Your answer
Fifth child's age:
Your answer
Grade just completed in school:
Your answer
Allergies or other medical conditions:
Your answer
Emergency contact information
Name: *
Your answer
Phone number: *
Your answer
Upon completion of this form, I understand that I am granting Massaponax Baptist Church the right to photograph/videotape my child in connection with VBS. I authorize Massaponax Baptist Church, its assigns and transferees to copyright, use and publish the same in print and/or electronically.

I agree that Massaponax Baptist Church may use such photographs/video of me or my child with or without my name for any lawful purpose including for example such purposes as publicity, illustration, advertising and web content.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy