CHILD REGISTRATION FORM
VBS 2024
Registering Parent:
*
First Name
Last Name
Email:
example@example.com
Phone Number:
*
Please enter a valid phone number.
Do you accept text messages?
Yes
No
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child(ren) you are registering:
*
Emergency name & number in the event you cannot be reached.
*
I agree that the church may feature my child(ren) in broadcasts, print media, on the church website, and in publications or programs.
*
Please Select
No
Yes
Please feel free to add any pertinent information regarding your child(ren) or a friend they would like to be placed with:
Will your family be attending the Glow in the Dark Party at Johnston Memorial Park on Friday, July 12th @ 6:30pm?
Yes
No
Submit
Should be Empty: