2021 VBS Registration
Event Timing: April 5th - 9th, 2021 from 5:45-8:15 pm
Event Location: Bloomfield Baptist Church
106 Springfield Rd  Bloomfield, KY 40008

Contact us at (502) 252-8435 or dvinson@bloomfieldbaptist.org
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VBS Participant Name *
VBS Participant Grade *
Allergies/Special Instructions:
Parent/Guardian Name(s) *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Address
Does your family regularly attend worship?
Clear selection
If yes, where?
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Relationship to Participant *
The following people have permission to drop off/pick up my child: *
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