2024 VBS Registration

2024 VBS Registration form

* Indicates required field

Child's Name *

First

Last

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Birth date *

Last Grade completed in school *

Medical Information or other information we need to know. (Please include any food allergies) *

Emergency Contacts *

Dismissal Information *

Other Information

Dose your child attend church? If so, where? *

If your child is visiting our church, who is he a guest of? *

May we have permission to photograph your child? *

Yes No

May we have permission to use your child's photograph for the purpose of promotion? *

Yes No

Submit