United Christian Church VBS Registration Form
Please provide the necessary details to register your children for the Vacation Bible School.
Child's Full Name
*
First Name
Last Name
Grade entering in the fall
Grade entering in the fall
Child's Age
*
Child's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergies or Medical Conditions
Special Instructions or Notes
Photo Consent
I consent to my child's photos being used for church-related publicity and social media.
Register
Should be Empty: