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VBS REGISTRATION
VBS REGISTRATION FORM
VACATION BIBLE SCHOOL
6PM - 8PM
JUNE 5 – 9, 2021
For all children that have completed (current) Kindergarten – 6th Grade
Child First Name
Child Last Name
Child's Date of Birth
Last Grade COMPLETED in school
Kindergarten
1st
2nd
3rd
4th
5th
6th
Parent/Guardian First Name
Parent/Guardian Last Name
Parent Email
Address 1
Address 2
Country
City
State
Zip/Postal Code
Parent Cell Number
Parent Work Number
Parent Home Number
Medical or other information we need to know (Please include any food allergies. Please review Snack Menu below this form.)
Emergency Contacts
First Name
Last Name
Phone Number
First Name
Last Name
Phone Number
Other Information
Do you attend a local church
Yes
No
If so, where?
Can your child be photographed for in-house use only?
Yes
No
CHILD PICKUP INFORMATION
(Persons responsible for picking up the child must be 18 year old or older)
First Name
Last Name
Phone Number
First Name
Last Name
Phone Number
First Name
Last Name
Phone Number
If there are any custody issues, please let us know:
Send
File not found.
