Connection Church VBS 2019 Registration
Use this form to register your child (or children) for VBS on June 24-28 at Connection Church
Parent Information
Please only fill out one form per family
Parent Name *
Your answer
Parent Cell Phone *
Your answer
Alternate Phone
Your answer
Parent E-mail *
Your answer
Mailing Address
Your answer
Do you attend church anywhere?
If you do not currently attend Connection Church, please list who invited you or how you found out about VBS.
Your answer
May we have your permission to photograph your child(ren) and use it for the purpose of promotion?
Student Information
Student First and Last Name *
Your answer
Student Age (This program is for 5 year olds (Pre-K) through students who are entering 5th grade in the Fall) *
Your answer
Last Completed Grade in school *
Your answer
Medical Concerns *
Please list any possible health concerns or allergies. If no health concerns, please write "none."
Your answer
Other Things to Know
Please provide any other information you would like us to know.
Your answer
Do you have another child to register? *
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