VBS registration

VBS Registration

* Indicates required field

Name *

First

Last

Grade Entering *

Age *

Birthday *

Parent/Guardian Name *

Home Address *

Home Phone *

Emergency contact person *

Cell Phone *

Emergency contact phone number *

Home Church *

Email Address *

Allergies or other medical conditions *

Is Transportation needed? *

Yes No

Alternate People that are allowed to pick up your child *

I give permission for my child to be photographed and videotaped during church activities. My child’s image may appear in print or online promoting the church’s activities. I understand that my child’s name will not be used to identify my child. *

Yes No

Submit