Calvary VBS Registration Form
Child Information
Child Number 1
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade Completed
Please Select
Pre-K
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Child Number 2
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade Completed
Please Select
Pre-K
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Child Number 3
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade Completed
Please Select
Pre-k
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Child Number 4
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade completed
Please Select
Pre-k
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Child Number 5
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade Completed
Please Select
Pre-k
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Child Number 6
Name
First Name
Last Name
Gender
Male
Female
Age
DOB
-
Month
-
Day
Year
Date
Grade Completed
Please Select
Pre-k
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Medications
Allergies
Parent Information
Parent Name
*
First Name
Last Name
Relationship
*
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
IMPORTANT:
Children will ONLY be released to leave with an adult listed below. When picking up children you must have your tag or driver's license.
My children are allowed to be released to leave with these adults:
*
Please check the box if you have more than 6 children at VBS.
Parent Signature
*
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