2022 - VBS Registration
August 5, 6, 7 - Ages Preschool through 5th Grade (We do have a Youth class this year)
Childs Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Other than the parents/guardians, who else can pick up the child?
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Childs Date of Birth
*
-
Month
-
Day
Year
Date
Please list any allergies your child may have:
*
Child's LAST grade completed in school (Remember VBS is for ages Preschool through 5th Grade, but we will have a Youth Class)
*
Please Select
Preschool
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Submit
Should be Empty: