VBS Registration Form

Please fill out and submit one form for EACH child attending. Your information will not be shared.

Once you have submitted your form, you will be redirected to a blank form. If you do not need to register anyone else, you may close the window.

VBS Registration Form

Child's Full Name

Email Address

Address

City

State

Zip Code

Date of Birth

Age

Phone Number

Secondary Phone Number

Do you receive texts? Do you receive texts? Yes No I would like to be informed of future events. I would like to receive inspirational messages.

Name of Parent or Guardian

Please list any medications, allergies, or disabilities we may need to know while caring for your child. (This information will be kept private.)

Please list an emergency contact and phone number.

Please list any siblings attending. (You will need to submit a separate form for each one.)

T-Shirt Size

Do you consent to photos or videos of your child being shared on our church website, Facebook page, You Tube, or any other social media? Do you consent to photos or videos of your child being shared on our church website, Facebook page, You Tube, or any other social media? No Yes

13 + 1 =