Vacation Bible School Registration
Email address *
Child's Name *
Your answer
Grade Most Recently Completed
Child's Birthdate
MM
/
DD
/
YYYY
Parent/Guardian Name(s)
Your answer
Home Address
Your answer
Parent/Guardian Phone Number(s)
Your answer
Names of People Authorized to Pick Up Child
Your answer
Emergency Contact Name (not parent/guardian)
Your answer
Emergency Contact Phone Number
Your answer
List any allergies or medical concerns here:
Your answer
Do you attend church anywhere?
Do you have additional children to register for VBS?
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