Vacation Bible School Registration

1
Your Name* This field is required.
First Name
Last Name
2
Email Address * This field is required.
example@example.com
3
Phone Number* This field is required.
Please provide the best phone number to reach you
4
Your Child’s Name* This field is required.
First Name
Last Name
5
Your Child’s Age* This field is required.
6
Grade Level* This field is required.
Please Select
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Ninth Grade
Tenth Grade
Eleventh Grade
Twelfth Grade
7
Gender* This field is required.
Male
Female
8
Does your child have any dietary restrictions? If no, please type N/A* This field is required.
9
Does your child have any known allergies or medical conditions? If no, please type N/A* This field is required.
10
How many days is your child able to attend KSA?* This field is required.
Please Select
1
2
3
4
11
Are you interested in attending any sessions with your child?* This field is required.
Please Select
Yes
No
Unsure
12
Please understand that transportation will not be provided* This field is required.
I understand
13
Parents will be required to sign a liability waiver and photo release form. Please type your name here to acknowledge that. Please note that this is not the waiver. Waiver will be provided for you to sign on the first day of VBS.* This field is required.
Should be Empty: