VBS 2019

Register HERE:

Child's Name:

Parent/Guardian Name

Address (Street Address, City, State and Zip)

Mailing Address (if different)

Phone Numbers

Home Phone

Work Phone

Cell Phone

Parent/Guardian Email

Age Information

Birth Date

Last Grade Completed in School

Medical Information

Medical Information - Medical or other information we need to know. (Please include any food allergies.)

Emergency Contacts (other than listed above)

Names & Phone Numbers

Dismissal Information

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 he/she a guest of?

How did you hear about this event?