2026 VBS Registration Form

2026 Registration Form

Vacation Bible School - August 10-14 - West Lorne Baptist Church
* Information is Confidential*
Student Name :
First & Last
Date of Birth:

MonthDayYear
Date
Age :
Gender:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Guardian:
Email
Phone:
Format: (000) 000-0000.
Alternate Phone:
Format: (000) 000-0000.
Person(s) whom the student lives with:
Allergies/ Reaction / Treatment:
Illness or Medical Conditions / Symptoms/ Treatment:
Emergency Contact #1 - Other than Parent / Guardian Name:
Relationship:
Phone:
Format: (000) 000-0000.
Emergency Contact #2 - Other than Parent / Guardian Name:
Relationship:
Phone:
Format: (000) 000-0000.

2026 Registration Form