Fredericksburg Presbyterian VBS
Please use this form to sign up for ROAR VBS - Life is wild - God is Good Vacation Bible School at Fredericksburg Presbyterian Church on Monday June 24th through Thursday June 27th from 6pm - 8:30pm. Then finish the week on Sunday during our VBS service featuring the children preforming the music they have learned.

Please make sure to fill out all required information and you MUST go to the bottom of the form and press the "SUBMIT" button to be registered. After you submit your registration, you will receive an email with more detailed information.

Family Information
Please fill out the following information that applies to all children attending VBS
Name of parent(s)/guardian(s) *
Your answer
Street address *
Your answer
City *
Your answer
Zip code *
Your answer
Home telephone *
Your answer
Parent/Caregiver's cell number 1 *
Your answer
Parent/Caregiver's cell number 2
Your answer
Email address *
An email will be sent to this address upon completion, please make sure this is accurate.
Your answer
Alternate pick-up person's name (optional)
Your answer
In Case of emergency, whom should be contacted 1st and 2nd? What is their relationship to the child/children?
Your answer
Permission to Use Photography - I grant to Fredericksburg Presbyterian Church the right to take photographs of my family in connection with its 2019 Vacation Bible School, being held at the church during the month of June. I authorize Fredericksburg Presbyterian Church, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Fredericksburg Presbyterian Church may use such photographs of my family with or without our names and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.
1st Child's Information
Child 1's first and last name *
Your answer
Child 1's age *
Your answer
Child 1's date of birth *
MM
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DD
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YYYY
Child 1's last grade completed *
Your answer
Child 1's allergies or other medical conditions (please include drug, food, and environmental allergies).
Your answer
2nd Child's Information (optional)
Child 2's first and last name
Your answer
Child 2's age
Your answer
Child 2's date of birth
MM
/
DD
/
YYYY
Child 2's last grade completed
Your answer
Child 2's allergies or other medical conditions (please include drug, food, and environmental allergies).
Your answer
3rd Child's Information (optional)
Child 3's first and last name
Your answer
Child 3's age
Your answer
Child 3's date of birth
MM
/
DD
/
YYYY
Child 3's last grade completed
Your answer
Child 3's allergies or other medical conditions (please include drug, food, and environmental allergies).
Your answer
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