VBS: Student Registration Form
Please fill out this form and click submit.
VBS will run August 19th-23rd from 9:00am-12:00pm.
Child Information
Child's Name
*
Child's Age
*
Please select all that apply.
3
4
5
6
7
8
9
10
11
Child's Grade (Fall 2024)
*
Please select all that apply.
Pre-K (3's & 4's)
Kindergarten
1st
2nd
3rd
4th
5th
Do your child have any allergies?
*
Please select one option.
Yes
No
If yes, please explain
Does your child have any medical issues you'd like us to be aware of:
*
Please select one option.
Yes
No
If yes, please explain
*
Parent Information
Parent/Guardian Name (s)
*
Phone
*
Work Phone
Email
*
This address will receive a confirmation email
Emergency Information
Emergency Contact 1
*
Phone
*
Emergency Contact 2
*
Phone
*
Doctor
*
Phone
*
Dismissal
Who may pick up your child at the end of each VBS day?
Name
*
Relationship
*
Name
*
Relationship
*
Photo Permission
May we use your child's photo on various social media platforms? (Facebook, Instagram, Church Website, etc.)
*
Please select one option.
Yes
No
Submit
Description
Please fill out this form and click submit.
VBS will run August 19th-23rd from 9:00am-12:00pm.
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