Roar Safari VBS Registration
We're so glad that you want to sign your child up for an exciting week at this year's Roar Safari VBS June 17-21, 2019. Please have your child here and ready for fun by 9 a.m. each day. The program ends with a provided lunch at noon. Parents and caregivers should pick up their student at noon and no later than 12:30.

Please complete this form to register your child. You can pay online or bring the payment of $25 per child/ $75 maximum per family to the office during regular hours or on the first morning of the program.

VBS 2019 Theme
Family Information
Name of Father *
Your answer
Name of Mother *
Your answer
Address *
Your answer
City *
Your answer
State and Zip *
Your answer
Home Phone *
Your answer
Parent/Caregiver Cell Phone *
Contact for who will be transporting child to VBS
Your answer
Parent/family email address *
Your answer
Emergency Contact
In case of emergency: Contact Name *
Your answer
Relationship to child *
Your answer
Emergency Contact Phone *
Your answer
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