VBS Registration

Please fill out the following form to register you child for VBS.  This information will not be shared with anyone except VBS staff.

 

Please complete the form below

Child's Name *
Child's Name
Second Child's Name
Second Child's Name
Third Child's Name
Third Child's Name
Fourth Child's Name
Fourth Child's Name
Please list any additional children with last grade completed.
Parent/Gaurdian Name *
Parent/Gaurdian Name
Address *
Address
Will your child/children need to ride the van?
Home Phone
Home Phone
Cell Phone *
Cell Phone
Would you like to receive invitations for upcoming events?
Medical or other information we need to know. (Please include any food allergies)
Emergency Contact 1 *
Emergency Contact 1
Emergency Contact 1 Phone *
Emergency Contact 1 Phone
Emergency Contact 2 *
Emergency Contact 2
Emergency Contact 2 Phone *
Emergency Contact 2 Phone
Who may pick up your children at the end of VBS? Must be 7 grade or older. Please list all who will pick them up.