VBS Registration
Each child MUST be registered individually
Child's Name *
Your answer
Gender *
Parent/Guardian Name *
Your answer
Address (street address, city, state, and zip code) *
Your answer
Mailing Address (if different)
Your answer
Home Phone # *
Your answer
Cell Phone #
Your answer
Work Phone #
Your answer
Email address *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Last grade completed in school *
Your answer
Medical Information (Medical or other information we need to know.) Please include any food allergies. *
Your answer
Emergency Contacts (other than listed above) Names and Phone numbers *
Your answer
Dismissal Information: Who may pick up your child at the end of each VBS day? *
Your answer
Are you a member of Prospect Baptist Church? *
If not, do you attend church?
If yes, where do you attend church?
Your answer
If your child is visiting our church, who is he/she a guest of?
Your answer
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