2023 Victory Baptist Church VBS Registration Form

1

Home Church* This field is required.

Victory Baptist Church

None

2

Today's Date* This field is required.

Date

3

Parent - First Name* This field is required.

4

Parent - Last Name* This field is required.

5

Parent - Birthday* This field is required.

Date

6

Street Address* This field is required.Apartment number or additional lines on the next slide

Physical Address

7

Street Address-Line 2i.e. Apartment Number (skip if not needed)

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City* This field is required.

9

State* This field is required.

10

Zip Code* This field is required.

11

Phone Number* This field is required.Emergency contact number

12

Email* This field is required.

13

Spouse/Other Guardian - First & Last namePlease fill out to authorize release of child(ren) to other individuals. These fields can be left blank if not necessary.

14

Spouse/Other Guardian's BirthdayOptional

Date

15

Street Address if differentOptional

16

Spouse or Other Guardian's Phone NumberOptional Unless needed for Emergency Contact info

17

In case of necessity or emergency, who should we contact first?* This field is required.Add name & number for other option.

1. Parent

2. Spouse/Other Guardian

18

Child's First name* This field is required.

19

Child's Last name* This field is required.

20

Gender* This field is required.

Male

Female

21

Child's Birth date* This field is required.

Date

22

Age as of June 10th* This field is required.

23

Grade in the fall* This field is required.

25

Do you have another child to register?* This field is required.

yes

no

26

Child's First name* This field is required.

27

Child's Last name* This field is required.

28

Gender* This field is required.

Male

Female

29

Child's Birth date* This field is required.

Date

30

Age as of June 10th* This field is required.

31

Grade in the fall* This field is required.

33

Do you have another child to register?* This field is required.

yes

no

34

Child's First name* This field is required.

35

Child's Last name* This field is required.

36

Gender* This field is required.

Male

Female

37

Child's Birth date* This field is required.

Date

38

Age as of June 10th* This field is required.

39

Grade in the fall* This field is required.

41

Do you have another child to register?* This field is required.

yes

no

42

Child's First name* This field is required.

43

Child's Last name* This field is required.

44

Gender* This field is required.

Male

Female

45

Child's Birth date* This field is required.

Date

46

Age as of June 10th* This field is required.

47

Grade in the fall* This field is required.

49

Do you have another child to register?* This field is required.

yes

no

50

Child's First name* This field is required.

51

Child's Last name* This field is required.

52

Gender* This field is required.

Male

Female

53

Child's Birth date* This field is required.

Date

54

Age as of June 10th* This field is required.

55

Grade in the fall* This field is required.

57

Do you have another child to register?* This field is required.

yes

no

58

Child's First name* This field is required.

59

Child's Last name* This field is required.

60

Gender* This field is required.

Male

Female

61

Child's Birth date* This field is required.

Date

62

Age as of June 10th* This field is required.

63

Grade in the fall* This field is required.

65

Do you have another child to register?* This field is required.

yes

no

66

Child's First name* This field is required.

67

Child's Last name* This field is required.

68

Gender* This field is required.

Male

Female

69

Child's Birth date* This field is required.

Date

70

Age as of June 10th* This field is required.

71

Grade in the fall* This field is required.

73

Do you have another child to register?* This field is required.

yes

no

74

Child's First name* This field is required.

75

Child's Last name* This field is required.

76

Gender* This field is required.

Male

Female

77

Child's Birth date* This field is required.

Date

78

Age as of June 10th* This field is required.

79

Grade in the fall* This field is required.

81

Do you have another child to register?* This field is required.

yes

no

82

Child's First name* This field is required.

83

Child's Last name* This field is required.

84

Gender* This field is required.

Male

Female

85

Child's Birth date* This field is required.

Date

86

Age as of June 10th* This field is required.

87

Grade in the fall* This field is required.

89

Special Needs/NotesPlease list any special needs your child or children may have. Please list the name of your child with the needs associated with him/her.

90

Promotion photos* This field is required.Only VBS related photos will be taken and no child will be personally identified on Victory Baptist Church's website and social media. A request can be made to remove pictures of your child from the website and/or social media at any time.

I do give Victory Baptist Church permission to use promotional photos or videos of my child.

I do NOT give Victory Baptist Church permission to use promotional photos or videos of my child.

91

Free Transportation is available!* This field is required.Will you be needing the use of our free transportation? If, yes, we will be in contact with you at the above address and/or phone number to schedule both pick-up and drop off times.

YESNO

92

VICTORY BAPTIST CHURCH ACTIVITY WAIVER* This field is required.In order for your child(ren) to participate in VBC's Vacation Bible School, please accept the following conditions.

93

Thank you so much for entrusting your child(ren) to us. We take this priviledge seriously and will do our very best to bring them closer to Jesus.

If you have selected the use of our free transportation, we will contact you with the scheduled pick-up and drop off times.

Parents, we strongly encourage you to attend our VBS with your children. Not only will they build lifelong memories, but you will be a great part of that memory as well.

Please Click SUBMIT to send your form. You will receive an email confirmation. If you do not please call us at (940) 300-1147 for assistance.If we are not able to answer at the time of your call, please leave a message and someone will call you back as soon as possible.