VBS REGISTRATION 2023

VBS REGISTRATION 2023
DATE: June 19-23

TIME: Monday-Thursday...1:30pm-3:30pm Friday...2:00pm-3:00pm (Closing Program)

AGES: 5 years old - Completion of 5th Grade
Child's Name*
Gender*
Address*

Address

Street Address Line 2

CityState / Province

Zip
Birth Date*

MonthDayYear
Date
Grade Just Completed*
Parent / Guardian Name*
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Relationship to Child*
Medical Conditions and/or Allergies
LIABILITY - I agree not to hold First Baptist Church liable for accidents or illnesses that may occur.*
PHOTO RELEASE - I agree to allow First Baptist Church to use photos and videos of my child for publication.*
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: