Surfside Community Fellowship VBS '23
Preregister your child for our VBS, June 12-15 from 6-8pm. Only one child per form submission.
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Child's Full Name *
Age *
Date of Birth *
Guardian's Full Name *
Grade Level Completed *
Is a sibling also attending VBS? *
Address *
City *
State *
Primary Phone *
Secondary Phone *
Email *
Emergency Contact Full Name *
Emergency Contact Phone *
Allergies or Special Needs? *
If so, what?
Person Responsible for Pickup after VBS (if different from guardian)
Pickup Person's Phone
Pickup Person's Relationship with Child
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