2026 - VBS REGISTRATION

VBS
JUNE 11-13
6-8 pm

LONG BEACH CHURCH OF CHRIST

Children's Registration
(ONE FORM FOR EACH CHILD)
Child's Name

First NameLast Name
Grade Completed
Birthday
Age
Food Allergies
Medical Concerns
Emergency Number
Format: (000) 000-0000.
Allergy & Medical Info For This Child
PARENT/GUARDIAN INFO
Name & Address (Parent/Guardian #1)

Name

Street Address

CityState / Province

Postal / Zip Code
Name & Address (Parent/Guardian #2)

Name

Street Address

CityState / Province

Postal / Zip Code
List Siblings Attending VBS
CHURCH AFFILIATION?
PERMISSION REQUEST:
VBS leaders have permission to photograph/film the child registered above during their participation in VBS programs. Photography will be used for in-house production and FaceBook posts about the VBS experience.
YOUR ANSWER TO PERMISSION REQUEST
Should be Empty:

PARENT/GUARDIAN INFO