VBS Registration - June 4-8, 2018
Please complete one per child you are registering! Cost is $25/child with a $60 cap/family. Scholarship  help is available.
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Child's name *
Child's age *
Child's gender *
Child's date of birth *
What grade is your child in as of Spring 2019? *
Name of parent(s) / guardian(s) child lives with *
Home address *
(please include street, city, zip)
Cell number for parent/guardian/caregiver *
Email address of parent/guardian *
What, if any, allergies does your child have? *
(medicine, food, etc.)
In case of emergency, who AND how do we contact them? *
(list name of contact AND their phone number)
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