2024 VBS Registration Form

2024 VBS Registration Form

Please complete a new form for each participant.
Participant's Name*

First NameLast Name
Participant's Birth Date*

MonthDayYear
Date
Participant's Gender*
Participant's T-Shirt Size*
Grade Completed & Age*
Parent's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Cell Number*
Please enter a valid phone number.
Parent's Email*
example@example.com
Emergency Contact's Name*

First NameLast Name
Emergency Contact's Phone Number*
Please enter a valid phone number.
Emergency Contact's Relationship to Child*
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.*
List adults authorized to pick up your child and their relationship to the child. (John Doe - neighbor)
In the event it is not a parent, please note a valid I.D. will be required at sign-out.
Alternate Phone Number
Please enter a valid phone number.
A light supper will be served each night at 5:30 pm. Will you attend? For no, put zero, or put the number of people that will join us for supper.*
How did you hear about VBS?*
Would you be interested in learning more about any of the following opportunities coming up? Select all that apply.

2024-2025 School Year with the Roanoke SDA Church SchoolSoap Making 101 ClassCooking Classes to Reverse Chronic DiseaseBible Studies
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