V.B.S. Registration 2022
Please fill out and submit this form to have your child registered for VBS 2022! There is space for 3 children on this form. There are limited spots available.
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Email *
Parent, Emergency, and Alternate Contact Information
Please fill out the parent information and at least 1 emergency contact for your child.
Parents First & Last Name *
Parents Phone Number *
Parents Email *
Parents Address *
City, State, Zip *
Emergency Contact Name *
Emergency Contact Relationship *
Emergency Contact Phone Number *
2nd Emergency Contact
2nd Emergency Contact Relationship
2nd Emergency Contact Number
Alternate Pick Up Name (if someone else is allowed to pick up you child please tell us the name(s) of the people)
Child Information
Please fill out the following information for your child for VBS. There is space for 3 children. PLEASE FILL IT OUT COMPLETELY.
1st Childs First and Last Name
Grade Entering in 2022
Clear selection
Do we have permission to have our child in photos that will be seen on social media for the church and children's ministry? (it will be on the Church Facebook page and Children's Ministry Private Facebook Group which we encourage you to join!)
Clear selection
Date of Birth
MM
/
DD
/
YYYY
Allergies or Medical Concerns
T-shirts are available for purchase for $12. During our family fun night we tie dye them! If you would like to purchase one please choose the size bellow, if not please mark NO. We are only ordering shirts upon request, there will be no extras.
Clear selection
2st Childs First and Last Name
Grade Entering in 2022
Clear selection
Do we have permission to have our child in photos that will be seen on social media for the church and children's ministry? (it will be on the Church Facebook page and Children's Ministry Private Facebook Group which we encourage you to join!)
Clear selection
Date of Birth
MM
/
DD
/
YYYY
Allergies or Medical Concerns
T-shirts are available for purchase for $12. During our family fun night we tie dye them! If you would like to purchase one please choose the size bellow, if not please mark NO. We are only ordering shirts upon request, there will be no extras.
Clear selection
3rd Childs First and Last Name
Grade Entering in 2022
Clear selection
Do we have permission to have our child in photos that will be seen on social media for the church and children's ministry? (it will be on the Church Facebook page and Children's Ministry Private Facebook Group which we encourage you to join!)
Clear selection
Date of Birth
MM
/
DD
/
YYYY
Allergies or Medical Concerns
T-shirts are available for purchase for $12. During our family fun night we tie dye them! If you would like to purchase one please choose the size bellow, if not please mark NO. We are only ordering shirts upon request, there will be no extras.
Clear selection
Submit
Clear form
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