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VBS Registration Form
*
Indicates required field
Child's Name
*
First
Last
Church Affiliation:
*
Parent Name
*
First
Last
Do you give permission to have photographs of your child to be included in VBS or Church Event Photos?
*
Yes
No
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Age Information
Grade just finished
*
Kindergarten
1st- 2nd Grade
3rd- 4th Grade
5th- 6th Grade
Age
*
Medical Information
Does your child have any medical or other information we need to know?
*
Yes
No
If so, please list below
*
Emergency Contacts
(other than listed above)
Name
*
First
Last
Phone Number
*
Authorized Pickup 1
*
First
Last
Authorized Pickup 2
*
First
Last
Submit
About Us
Our Mission
Staff
Directions
Worship
Connect
Ministries
>
Children
Youth
Men on Mission
Women on Mission
Missions
Give
Events
Contact Us