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VBS 2023 Registration
Please fill out one per child
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* Indicates required question
Parent/Guardian's First and Last Name
*
Your answer
Child's First and Last Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Grade Level for 2023-2024 School Year
*
PreK
K
1st
2nd
3rd
4th
5th
Other:
Home address
*
Your answer
Phone Number
*
Your answer
Is this the primary number to contact in case of emergency during VBS?
*
Yes
No
If not, what number should we contact first?
Your answer
Email Address
*
Your answer
Preferred Method of Contact
*
Provided Phone Number
Provided Email
Additional Emergency Contact
*Please include name, relation and phone number*
*
Your answer
Who can pick up your child?
*
Parent/ guardian names listed above
Emergency contact listed above
Other:
Required
Does your child have any allergies?
Your answer
Does your child need any special accommodations or things we should know about?
Your answer
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