2023 Community VBS Registration

Community VBS - Clap Your Hands & Stomp Your Feet!

St. Giles, Christ Pres., and Eternity Church invite you to join us for our first ever Community VBS! VBS for Pre-K - 5th grade will be held at St. Giles Church July 12-14 from 5:30-8 p.m. each evening, with dinner provided for families. Mark your calendars for a wonderful time together with our church communities!
How many children would you like to register?*
Child #1 Name

First NameLast Name
Child #1 Birthday

MonthDayYear
Birthday
Child #1 Gender
Child #1 Grade Completed
Child #2 Name

First NameLast Name
Child #2 Birthday

MonthDayYear
Birthday
Child #2 Gender
Child #2 Grade Completed
Child #3 Name

First NameLast Name
Child #3 Birthday

MonthDayYear
Birthday
Child #3 Gender
Child #3 Grade Completed
Child #4 Name

First NameLast Name
Child #4 Birthday

MonthDayYear
Birthday
Child #4 Gender
Child #4 Grade Completed
Child #5 Name

First NameLast Name
Child #5 Birthday

MonthDayYear
Birthday
Child #5 Gender
Child #5 Grade Completed
Child #6 Name

First NameLast Name
Child #6 Birthday

MonthDayYear
Birthday
Child #6 Gender
Child #6 Grade Completed

This is a fill in the blanks field. Please add appropriate blank fields and text.
Parent/ Guardian 1*

First NameLast Name
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
Email*

Confirmation Emailexample@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Enter contact information for second parent or guardian?*

YesNo
Parent/ Guardian 2

First NameLast Name
Primary Phone Number

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
E-mail

Confirmation Email

Emergency Contact*

First NameLast Name
Relationship to Child*
Phone Number*

Area CodePhone Number
Who (adult) can pick up my child?*
Please list any food allergies your child/children may have: List N/A if none*
For example: John Doe- peanut allergy, Jane Doe- seafood
Please list any medical concerns your child/children may have: List N/A if none*
For example: John Doe- diabetes, Jane Doe- extreme reaction to wasp stings
Preferred Hospital*
Doctor*
Doctor's Phone Number*

Area CodePhone Number
Do you give permission for photos of your children to be used for publication?*

YesNo
What church do you attend?
Should be Empty:

Community VBS - Clap Your Hands & Stomp Your Feet!