VBS Registration

VBS Registration

Monday, June 26 - Friday, June 30 9:00 a.m. - 12:00 p.m.
Ages 4 years - 5th Grade
Child Information

You can include up to three children from the same household on one registration
Child's Name*

First NameLast Name
Age*
Food or Medication Allergies*
Child's Name

First NameLast Name
Age
Food or Medication Allergies
Child's Name

First NameLast Name
Age
Food or Medication Allergies
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Alternate Phone Number
Please enter a valid phone number.
I understand that the First Presbyterian Church of Royal Oak, its staff, and/or volunteers are not responsible in the case of accident and/or injury. In the event of an emergency where medical treatment is required, I give my permission to the church staff/volunteer to obtain the services of a licensed physician for my son/daughter. I will be contacted as soon as possible at the numbers listed above. My signature reflects my agreement to the above terms and authorizes my son/daughter to fully participate in STELLAR VBS.
I am interested in a low cost childcare option from 12:00 p.m. - 3:00 p.m. (if available)*

YesNo
Should be Empty:

Child Information