VBS REGISTRATION
BABER AFRICAN METHODIST EPISCOPAL CHURCH
Name
First Name
Last Name
IF A MINOR, NAME OF PARENT/GUARDIAN
First Name
Last Name
CLASS (Select one)
PREK/KINDERGARTEN - GRADE 3
GRADE 4 - 6
MIDDLE AND HIGH SCHOOL
YOUNG ADULTS (18-25)
ADULTS
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EMAIL
example@example.com
PHONE NUMBER
EMERGENCY CONTACT
First Name
Last Name
EMERGENCY CONTACT PHONE
Please enter a valid phone number.
Submit
Should be Empty: