VBS Child Registration
Please fill out one per child
Child's Name *
Child's Gender *
Child's Age *
Child's Date of Birth *
MM
/
DD
/
YYYY
Last Grade Completed *
Name of Parent(s) *
Street Address *
Phone Number *
Email Address
Home Church
Allergies, Medical Conditions, or Special Needs:
In case of emergency, contact: Please put name, number, and relationship to child below *
Submit
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