WPPC VBS Registration

WPPC VIRTUAL VBS 2020 REGISTRATION

VBS is available for children 3 years old to just completed 5th grade.
How many children are you registering?*
Child Information
First Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child (including food allergies).*
Second Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child (including food allergies).*
Third Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child (including food allergies).*
Fourth Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child (including food allergies).*
Parent Information
Parent/Legal Guardian Name*

First NameLast Name
Email
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
The week before VBS bags filled with arts and craft supplies will be available for a suggested $10.00 cash donation. Would you like to reserve a bag(s)?*

YesNo
Should be Empty:

WPPC VIRTUAL VBS 2020 REGISTRATION