Waterville VBS 2018
Registration Form

PLEASE FILL OUT A REGISTRATION FORM FOR EACH CHILD (for those with multiple children, you get multiple entries for the gift card, so there is a little ray of sunshine there)

Register online by Tuesday, July 31 for a chance to win a Highway 2 Brew Gift Card!


August 6-10 (Monday-Friday)
9:00am-12:00pm each day
Federated Church, Waterville
224 W. Ash St.

Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Participant's Gender *
Date of Birth *
MM
/
DD
/
YYYY
Last School Grade Completed *
Parent(s) Names *
Your answer
Email Address (needed for online registration) *
Your answer
Parent Phone Number #1 *
Your answer
Parent Phone Number #2
Your answer
Physical Address *
Your answer
Dietary Restrictions *
Allergies or other medical conditions *
Anything you'd like us to be aware of?
Your answer
Non-parent Emergency Contact Name *
Your answer
Non-parent Emergency Contact Phone Number *
Your answer
Non-parent Emergency Contact Relationship to Participant
Your answer
Submit
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