VBS_Registration_2017

VBS 2019 Pre-Registration Form

* Indicates required field

Child's Name *

First

Last

Parent/Guardian Name *

First

Last

Child's Address *

Line 1

Line 2

City

State

Zip Code

Country

Mailing Address *

Home Phone Number *

Work Phone Number *

Cell Phone Number *

Email *

What is your child's age? *

Last grade completed in school: *

Does child have medical or allergy needs? *

Yes No

List Medical Needs *

Emergency Contact #1 *

Emergency Contact #2 *

Who may pick up your child at the end of each VBS day? *

Does your child attend Sunday School? If so, where? *

IF you are visiting our church, who are you a guest of? *

May we have permission to photograph your child? *

Yes No

Photo promotion *

Yes No

Submit