Vacation Bible School Registration
Complete the registration details for your child and submit your contact information.
For children from age 1 to age 12.
Participant's Full Name
*
First Name
Last Name
Participant's Age
*
Grade Completed
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Other
Second Participant's Full Name
First Name
Last Name
Participant's Age
Grade Completed
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Other
Third Participant's Full Name
First Name
Last Name
Participant's Age
Grade Completed
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Other
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who is authorized to pick up your child? (If different than those listed above)
I have a home church that I attend.
Yes
No
I would like to be contacted about attending Willow Oak Baptist Church.
Yes
No
Signature (I allow a digital signature as my legal signature)
*
Sign here
Medical Form and Liability Waiver
Should be Empty: