2023 VBS Registration Form

VBS Registration - July 10-14

Please fill out the form completely.
Student Name

First NameLast Name
Age (as of July 8)
Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian E-mail
example@example.com
Emergency Contact
Home Number
Format: (000) 000-0000.
Work/Mobile Number
Format: (000) 000-0000.
Approved Adult(s) For Pickup*
Enter full names of every adult allowed to pick up your children including parents.
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:

VBS Registration - July 10-14