2022 VBS Registration

June 27th-July 1 from 9:00 am to Noon | We would love for you to join us for our VBS Family Night on Friday, July 1st from 5:30 to 7:30 pm.

Child's Name (First/Last)

*

Parent/Guardian Name (First/Last)

*

Address

*

Phone

*

Email

*

This address will receive a confirmation email

Grade Entering

*

Please select one option.

Pre-School Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Date Of Birth For Pre-School (N/A If In Grade School)

*

Potty Trained (This Is Required For Pre-School)

Please select one option.

Yes No

Does This Child Have Any Medical Concerns Or Allergies?

*

Please select one option.

Yes No

Please Explain Any Medical Concerns Or Allergies

*

First Emergency Contact (Name/Phone Number)

*

Second Emergency Contact (Name/Phone Number)

*

List Any Additional Authorized Persons For Pickup

*

Do You Agree To Contact The Church If You Would Not Like Photos Of Your Child To Be Taken At VBS?

*

Please select one option.

Yes No

Are You Interested In Joining Us For Our Family Night From 5:30-7:30 pm On July 1st?

*

Please select one option.

Yes No

If You Are Visiting Our Church, How Did You Hear About VBS?

Do You Regularly Attend A Different Church In The Area?

Please select one option.

Yes No

If So, Which Church Do You Attend?

Description

June 27th-July 1 from 9:00 am to Noon

We would love for you to join us for our VBS Family Night on Friday, July 1st from 5:30 to 7:30 pm.

Please Fix the Following

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