VBS 2019 Registration
June 23-27, Sunday- Thursday
Child's Name
Your answer
Birth date
MM
/
DD
/
YYYY
Grade Completed
Your answer
Age
Your answer
Gender
Parent First & Last Name
Your answer
Address
Your answer
Zip
Your answer
Cell Phone
Your answer
Email
Your answer
Emergency Contact
Your answer
Emergency 2 Phone Numbers
Your answer
Relation to Child
Your answer
Special needs or allergies
Your answer
Person Responsible for Pick Up
Your answer
Their Phone Number
Your answer
Relation to Child
Your answer
Are there siblings in this VBS?
List their names:
Your answer
T-shirt Size
I agree to allow photos of my child to be used in church presentational materials.
How did you hear about our VBS?
Your answer
Are there other siblings or friends that will be dismissed with your child?
If so, list their names
Your answer
Any special notes or comments
Your answer
Submit
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