VBS

2019 VBS Registration

(Secured Online Form)

* Indicates required field

Child's Name *

First

Last

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Numbers

Home/Cell Number *

Work Number *

Email *

Birthday *

Last Grade Completed in School *

Medical and Allergy Information We Need to Know *

Emergency Contacts *

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

Other Information

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

If your child is visiting our church, who is s/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