VBS Registration 2019
Email address *
LAST Name of Child *
Your answer
FIRST Name of Child *
Your answer
Please Choose the CHILD'S GRADE LEVEL. This is the grade the child will be entering THIS FALL. Mark only one. *
Required
LAST Name(s) of PARENTS/GUARDIANS (Grandparents may register children, but please give us the Parent's name(s).) *
Your answer
FIRST Name(s) of Parents *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
Address *
Your answer
Who will pick up the child? *
Your answer
Special Needs for Food, Insect or Contact Allergies (If there are none, please type "none".) *
Your answer
You are invited to Friday's closing service & lunch (11:00 a.m.). Does your CHILD plan to attend? *
How many additional family or friends might attend? (If registering more than one child, you only need to answer this one time.)
Your answer
Home Church (Check all that apply.) *
Required
I would like more information about
I acknowledge that... *
Required
A copy of your responses will be emailed to the address you provided.
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