VBS Online Registration
Email address *
Parent(s) Name *
Your answer
Phone Number (Best # to reach you during VBS) *
Your answer
Alternate Phone Number
Your answer
If you were invited to VBS by someone, who invited you?
Your answer
Child Name (#1) *
Your answer
Birthdate *
Your answer
Grade Completed *
Your answer
Child Name (#2)
Your answer
Birthdate
Your answer
Grade Completed
Your answer
Child Name (#3)
Your answer
Birthdate
Your answer
Grade Completed
Your answer
Address *
Your answer
E-mail Address
Your answer
If your family regularly attends church, where do you attend?
Your answer
Emergency Contact (other than parent) *
Your answer
Emergency Contact Primary Phone Number *
Your answer
Emergency Contact Secondary Phone Number
Your answer
Medical Release Information *
Doctor's Name(s)
Your answer
Doctor's Phone Number
Your answer
Allergies? Please list child's name and any allergies.
Your answer
Any additional information we should know?
Your answer
In case of a medical emergency, I hereby give permission to Grace Hill Church to secure proper treatment or hospitalization for the child(ren) on this registration form. *
*Your typed signature on this form gives us permission in case of emergency.
Your answer
Please note: Grace Hill Church will make every attempt to reach the parent/guardian listed and/or the emergency contact on this registration form.
If you have any special concerns regarding an emergency, please let us know.
Your answer
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