VBS Registration
Vacation Bible School is June 24-28 from 8:30a-Noon. It is for children who have completed Kindergarten through the 5th grade.
Child Information
Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Last Grade COMPLETED
T-Shirt Size
Need Early Drop-off? (7:30a)
Parental Information
Parent/Guardian Name
Your answer
Address
Your answer
Home #
Your answer
Cell #
Your answer
Work #
Your answer
Email
Your answer
May we have permission to photograph your child?
May we have permission to use your child's photograph for the purpose of promotion?
Safety Information
Allergies
Your answer
First Emergency Contact Name
Your answer
First Emergency Contact Phone #
Your answer
Second Emergency Contact Name
Your answer
Second Emergency Contact Phone #
Your answer
Please list all persons (and relationship) authorized to pick up your child below:
Your answer
Submit
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