You can always press Enter⏎ to continue
Now create your own Jotform - It's free!
Create your own Jotform
VBS | Around Gods World
Please provide all required details to register your child for VBS. If you have any question's, please feel free to contact office@xeniachurch.org
START
1
Parent / Guardian Names
*
This field is required.
If only (1) parent, please apply "N/A" to the blank field.
Guardian 1 / First Name
Guardian 1 / Last Name
Guardian 2 / First Name
Guardian 2 / Last Name
Guardian 1 / Phone #
Guardian 2 / Phone #
Please enter your email
Previous
Next
Submit
Press
Enter
2
Child Information
*
This field is required.
Child 1 If you have more than one child registering for VBS, please click "NEXT" to continue to the next child information form. If only registering one, please skip the next few forms until the next section.
CHILD 1 / FIRST NAME:
CHILD 1 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
3
Child Information
Child 2
CHILD 2 / FIRST NAME:
CHILD 2 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
4
Child Information
Child 3
CHILD 3 / FIRST NAME:
CHILD 3 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
5
Child Information
Child 4
CHILD 4 / FIRST NAME:
CHILD 4 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
6
Child Information
Child 5
CHILD 5 / FIRST NAME:
CHILD 5 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
7
Child Information
Child 6
CHILD 6 / FIRST NAME:
CHILD 6 / LAST NAME:
AGE:
GRADE:
ALLERGIES:
Previous
Next
Submit
Press
Enter
8
Home Congregation
If Applicable.
Previous
Next
Submit
Press
Enter
9
Photo Approval
*
This field is required.
Do you give Xenia Church of Christ the authorization to take photos of your children and use on our Facebook / Instagram page or website?
YES
NO
Previous
Next
Submit
Press
Enter
10
Comments
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
10
See All
Go Back
Submit