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VBS Maker Fun Factory - Created by God, Built for a Purpose
Registration Form
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Open Registration for children who have completed K-5th Grade *Infant-Pre-K classes are available only for children of volunteers
Child's Name
*
Your answer
Child's gender
*
Female
Male
Child's age
Your answer
Child's date of birth
*
MM
/
DD
/
YYYY
Last completed school grade
*
Your answer
Name of parent(s)
*
Your answer
Street address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Home phone
Your answer
Mom's cell
Your answer
Dad's cell
Your answer
Caregiver's cell
Your answer
Parent's email address
*
Your answer
Home church
*
VBCC
Other:
Allergies or other medical conditions
Your answer
Emergency contact
*
Your answer
Phone
*
Your answer
Relationship to child
*
Your answer
Crew number or name (for church use only)
Your answer
I acknowledge that my child may be photographed or videotaped while attending Virginia Beach Community Chapel's Vacation Bible School, July 24-28, 2017, and their photos/videos may be used in promotional materials.
I do not wish to have my child photographed or videotaped.
Name
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Your answer
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