JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Landmark Missionary Baptist Church VBS Registration
Free registration is available for students 5-years-old, on or before September 1, 2021, through students completing 8th grade.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Untitled Title
Join us as we explore God's purpose for our lives!
Student's Name
*
Your answer
Gender
*
Female
Male
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Age as of September 1, 2021
*
Your answer
Last school grade completed
*
Pre-Kindergarten
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Required
Parent/Guardian
*
Your answer
Parent/Guardian Cell
*
Your answer
Parent/Guardian
Your answer
Parent/Guardian Cell
Your answer
Emergency Contact
*
Your answer
Emergency Contact Cell
*
Your answer
Relationship to child
*
Your answer
Person other than parent authorized to pick up your child *MUST BE AT LEAST 18 YEARS OLD
*
Your answer
Permission to upload a photograph or video of your child to social media
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
