2019 JBC VBS Registration Form
Please complete a separate form for each child attending. Thank you!
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP code *
Your answer
Home phone *
Your answer
Cell phone *
Your answer
Parent/Guardian Name(s) *
Your answer
In case of emergency, contact: *
Your answer
Allergies or other medical condition: *
Your answer
School grade going into: *
Name of home church, if any: *
Your answer
Siblings also attending VBS: *
Your answer
I understand that my child may be photographed or videotaped for a publicity video displaying their week at VBS played at the church, on the church website and shared with others. *
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