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2023 VBS: Ready, Set, Move...Follow Jesus Here, There, and Everywhere
***Please fill out a registration form for
EACH CHILD
(Ages 3-10/Grades Preschool-5th)!***
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JUNE 11-14 from 5:30-7:30 at Southeastern Church of Christ
June 14 is Family Fun Night (Parents required to attend)
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Street Address (House Number and Street)
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Home Phone
*
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Email
*
Your answer
Emergency Contact Number
*
Your answer
Allergies/Special Needs (Write none if not applicable)
If yes, please explain.
*
Your answer
Student's Current Age
*
Choose
3
4
5
6
7
8
9
10
11
Grade Completed
*
Choose
Preschool
Pre-K
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Not in school yet
T-Shirt Size (Select one for student on this form)
We hope to provide a t-shirt for each student this year if registered by June 1st.
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
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