VBS Registration

Parent or Guardian #1(Required)

First Last

Parent or Guardian #2

First Last

Home Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Email of Parent or Guardian(Required)

Enter Email Confirm Email

Primary Contact Person for Emergencies(Required)

First Last

Primary Cell Phone for Emergencies(Required)

Additional Cell Phone for Emergencies

Children Attending (click on plus+ symbol to add more rows)(Required)

Child's Name

Grade Completed

Age

T-Shirt Size

Any food allergies?

Any medical conditions?

How did you hear about us?

What church do you regularly attend if any?

List anyone authorized by you to pick up your child, and the days they will do so

Permission to include your child in photos taken during the week?(Required)

I agree

The information above is correct, including any medical concerns or allergies(Required)

I agree