VACATION BIBLE SCHOOL REGISTRATION
Fill out the form to register your child for VBS! Your information is confidential.
Personal Information
Child's Name
*
First Name
Last Name
Other Children (Please type first and last name, and last grade completed for each child)
Parent/ Guardian Name (First and Last)
*
Address
*
City, State, Zip Code
E-mail
Home Phone
-
Area Code
Phone Number
Work Phone
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Age Information
Birth Date
Last Grade Completed in School
*
Please Select
Pre-K (3-5)
Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Medical Information
Allergies and/or medical conditions
Please include any food allergies
Emergency Contacts
Full Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Full Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Dismissal Information
Who may pick up your child at the end of VBS each day?
*
May we take pictures of your child?
*
Yes
No
Do you attend a different church regularly? (If yes, please type the name in the box)
*
Register
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