VBS Registration Form 2018
Please register your child(children) for VBS 2018 "Jesus the Kingdom Builder: Strong Families, Churches, & Communities" by completing the form below. The dates are June 4 - 15, 2018. Please fill in all fields.
Choose one of the following options: *
Name *
Your answer
Age *
Your answer
Gender *
Birth Date *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Work Phone *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
E-mail
Your answer
Parent or Guardian's Name *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Allergies or other Medical Condition *
Your answer
Name of Home Church
Your answer
Do you need to be picked up by church van? *
Required
Do you need to be taken home by church van? *
Required
Today's date: *
mm/dd/yy
Your answer
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