Springdale Baptist Church VBS 2024 Registration
VBS is available for children Pre-K thru 12th Grade
Child Information
Child's Name
*
First Name
Last Name
Child's Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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Day
Please select a year
2024
2023
2022
2021
2020
2019
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1924
1923
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1921
1920
Year
Last Grade Completed
*
Please Select
Pre-K
Kindergarten
1-2
3-4
5-6
Does the child attend Sunday school anywhere?
*
Yes
No
Where?
Medical or other information we may need to know about the child (including food allergies).
*
Child Release Information
Parent/Legal Guardian Name
*
First Name
Last Name
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Names of Persons to which the child (children) may be released to each night after VBS (Please provide at least two)
*
First Name
Last Name
Full Name
*
First Name
Last Name
Full Name
First Name
Last Name
Full Name
First Name
Last Name
Are there any persons to which the child (children) may NOT be released to?
*
Yes
No
Who may you child (children) NOT be released to?
Emergency Contact 1 (other than parent/guardian listed above)
*
First Name
Last Name
Emergency Contact 1 Phone Number
*
Emergency Contact 2 (other than parent/guardian listed above)
*
First Name
Last Name
Emergency Contact 2 Phone Number
*
Media Release
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.
I Agree
Submit
Should be Empty: