2022 Vacation Bible School Registration
Please fill in the form below to register:
Child 1
Name
*
First Name
Last Name
Birthday
*
-
Month
-
Day
Year
Date
Age
*
Grade Just Completed
*
VBS Class
*
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
(Based on Grade just completed)
Child 2
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Age
Grade Just Completed
VBS Class
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
(Based on Grade just completed)
Child 3
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Age
Grade Just Completed
VBS Class
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
Based on Grade just Completed
Child 4
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Age
Grade Just Completed
VBS Class
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
Based on Grade just Completed
Child 5
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Age
Grade Just Completed
VBS Class
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
Based on Grade just Completed
Child 6
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Age
Grade Just Completed
VBS Class
PrePrimary (4s & 5s)
Primary (Grades 1-2)
Middler (Grades 3-4)
Junior (Grades 5-6)
Teens (Grades 7-12)
Based on Grade just Completed
Parent / Guardian
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Alternate Phone Number
-
Area Code
Phone Number
E-mail
Home Church
Guest Of
Allergies / Comments
How Did You Hear About VBS
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