VBS 2024 - Participant Registration

MonthDayYear
Today's Date

MonthDayYear
VBS 2024
Participant Registration

June 17-21, 2024
9am-12pm, Mon-Thurs

9am - 12:15pm, Fri
General Information
Number of Children You Are Registering
- Child #1
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age:
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Child #2
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Child #3
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Child #4
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Child #5
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Child #6
- Full Name
  
  First NameLast Name
- Birth Date:
  
  MonthDayYear
- Age
  as of VBS start date
- School Grade (next year!)
  as of Sept. 2022
- Gender
- Parent/Guardian Info:
- Full Name
  
  First NameLast Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Home Phone
  Format: (000) 000-0000.
- Work Phone
  Format: (000) 000-0000.
- Cell Phone
  Format: (000) 000-0000.
- E-mail
- Medical/Allergy/Emergency Contact Information
- Medical Conditions:
  Any medical conditions about your child that will help us should an emergency occur.
- Known Allergies:
  Any known allergies that your child has that will help direct us in making decisions for your child.
- Special Needs:
  Does your child have special needs? If so please specify.
- Other Helpful Info:
  Any other helpful medical or behavioral conditions about your child that will be helpful to us, or anything you want us to know.
- Emergency Contact Name #1:
  
  First NameLast Name
- Emergenct Contact Phone #1:
  Format: (000) 000-0000.
- Emergency Contact is same as Parent/Guardian?
- Emergency Contact Name #2:
  
  First NameLast Name
- Emergenct Contact Phone #2:
  Format: (000) 000-0000.
- Authorized Pickup Person(s)
- Pick-up person a volunteer at VBS?
- Pick-up person same as Parent/Guardian?
- NAME: Authorized Pickup #1
  
  First NameLast Name
- Relationship to Participant (Authorized Pickup #1)
- PHONE: Authorized Pickup #1
  Format: (000) 000-0000.
- NAME: Authorized Pickup #2
  
  First NameLast Name
- Relationship to Participant (Authorized Pickup #2)
- PHONE: Authorized Pickup #2
  Format: (000) 000-0000.
- NAME: Authorized Pickup #3
  
  First NameLast Name
- Relationship to Participant (Authorized Pickup #3)
- PHONE: Authorized Pickup #3
  Format: (000) 000-0000.
- NAME: Authorized Pickup #4
  
  First NameLast Name
- Relationship to Participant (Authorized Pickup #4)
- PHONE: Authorized Pickup #4
  Format: (000) 000-0000.
- Church Affiliation
- Church Member status:
- Church Affiliation:
  Name of home church (if any)
- Guest Of: (optional)
  
  First NameLast Name
- PHOTOS: Photographs taken during VBS are used for our wrap-up movie that we show parents in our closing ceremony. The movie will not be shown online. Individual names will not be associated with any picture taken, and pictures will not be posted on Facebook.*
- Choose days your child(ren) will attend:
- How did you hear about VBS?
  
  Other
- Comments/Questions
- Should be Empty: