In The Wild VBS Registration Form
Please fill out a form for EACH child attending.
Last Name *
First Name *
Age *
Birthdate *
MM
/
DD
/
YYYY
Last Completed Grade *
Gender *
Parent/Guardian Name *
Phone Numbers *
Street Address *
Mailing Address (if different)
Email Address *
T-Shirt Size *
Emergency contact 1 (Name & Number) *
Emergency contact 2 (Name & Number) *
Special Concerns or Comments *
(List all allergies, medications, medical conditions, etc..)
Please remember to arrive by 5:45pm on June 24th to sign the waiver. Thank you and see you soon!
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