VBS Child Registration
VBS DATES : June 11,12,13 Time: 9am - 12pm
Address: 405 M-37, Hastings, MI 49058
Contact Church office: (269) 945-5463
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First Name *
Last Name *
Child's Gender *
Child's grade level for this next school year *
Parents Name *
Parent Phone Number *
Parent Email *
Alternate Pick up Person for Child?
Alternate Emergency Contact (Name & Phone Number) *
What days will your child attend? *
Medical Concerns *
If yes to medical concerns, please explain here:
Food Allergies *
If yes to allergies, please explain here:
Parent, are you interested in staying? *
How did you hear about our VBS?
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