VBS 2019 Registration Form
Email address *
First name of child (one response per child please) *
Please enter child's first name
Your answer
Last name of child *
Please enter child's last name
Your answer
Child's preferred first name
Please enter your child's preferred first name if different than above
Your answer
Going to grade *
Which school grade will your child will be attending in September?
Age *
What is your child's age?
Street address
Please enter your street address. Required only for youngest child entered.
Your answer
City
Please enter your city. Required only for youngest child entered.
Your answer
Postal Code *
Please enter your postal code. Required only for youngest child entered.
Your answer
Care Card number *
Please provide your child's BC Care Card number.
Your answer
Parent/Caregiver name *
Specify the name of the parent/caregiver of the child(ren) listed above.
Your answer
Parent/caregiver home number *
Your answer
Parent/Caregiver cell phone number
Specify the cell phone number at which the parent/caregiver can be reached (if different from home).
Your answer
Emergency contact name(If possible list someone other then the Parent/caregiver already named). *
Specify the name of the person who should be contacted in case of emergency.
Your answer
Emergency contact number *
Specify the phone number at which the emergency contact can be reached.
Your answer
Relationship of emergency contact to you *
Specify how you know the emergency contact.
Your answer
Allergies/Dietary restrictions
Does your child have any allergies or dietary restrictions? Please list.
Your answer
Notes
Anything else we need to know?
Your answer
How did you hear about us? *
To help direct future advertising efforts, we would appreciate knowing how you heard about us.
Do you have a Bible at home?
Name of home Church, if any?
If you regularly attend a Church, please let us know which one.
Your answer
May we use pictures of your child(ren) for informational or promotional purposes? *
A copy of your responses will be emailed to the address you provided.
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