2022 VBS Registration Form

VBS Registration

Please fill out the form completely.
Student Name

First Name Last Name
Birth Date

Month Day Year
Grade this Fall
Address

Street Address

Street Address Line 2

City State

Zip Code
Parent/Guardian E-mail
example@example.com
Emergency Contact
Home Number
Work/Mobile Number
Approved Adult(s) For Pickup
Allergies, Medical Alerts, or Activity Restrictions
How did you hear about VBS?
What church do you normally attend?
Any Other Information for us?
Should be Empty: