VBS Registration 2025
Grades K - 5
Child's Name
First Name
Last Name
Child's age
Child's date of birth
mm/dd/yyyy
Last school grade completed
Name of Parent/Guardian 1
First Name
Last Name
Phone Number (Parent/Guardian 1)
Please enter a valid phone number.
Name of Parent/Guardian 2
First Name
Last Name
Phone Number (Parent/Guardian 2)
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
Allergies, medical condition, or special needs:
Emergency Contact Information
In case of emergency, contact:
Name
Relationship to child:
Phone Number
Please enter a valid phone number.
How many people will attend VBS kickoff Sunday Family Picnic?
Submit
Should be Empty: