VBS

VBS

Please fill out this form in full for the first child of a family. If you are registering siblings, you may complete only what is required after the first child.

Child's First Name^*

Child's Last Name^*

Sex^*

Male
Female

Child's Birthdate^*

Last Grade Attended^*

Guardian Name^*

Contact Phone Number^*

Contact Email^*

Known Allergies/Conditions

Address

Address Line 1

City

Postal Code

Home Church

Emergency Contact Name

Emergency Contact Phone Number

I give permission for my child's picture to appear in the slideshow.^*

Name of friend child requests to be in group with (we'll try)

Any other requests? (i.e. siblings together, siblings NOT together, etc.?)

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