VBS Registration Form

VBS Registration Form

New Paris Church of the Brethren
Child Information:
First Child's Name

First NameLast Name
Gender
Birth Date

MonthDayYear
What grade will your child be in during the 2025-2026 school year?
Pre-K child: will a parent be staying with the child?
Pre-K child: How long will your child be staying with us?
Second Child's Name

First NameLast Name
Gender
Birth Date

MonthDayYear
What grade will your child be in during the 2025-2026 school year?
Third Child's Name

First NameLast Name
Gender
Birth Date

MonthDayYear
What grade will your child be in during the 2025-2026 school year?
Fourth Child's Name

First NameLast Name
Gender
Birth Date

MonthDayYear
What grade will your child be in during the 2025-2026 school year?
Fifth Child's Name

First NameLast Name
Gender
Birth Date

MonthDayYear
What grade will your child be in during the 2025-2026 school year?
Address

Street Address

Mailing address (if different from above)

CityState / Province

Postal / Zip Code
Medical Information
Medical Information: (please include any food allergies)
Parent/Guardian Information:
Parent/Guardian Name

First NameLast Name
Home Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail
Does your child need a Bible?
Emergency Contact
Name

First NameLast Name
Phone

Area CodePhone Number
Relationship to the child
Dismissal Information
Who may pick up your child at the end of the VBS day?
Other Information
Do you have a church home?
If yes, where?
May we have permission to photograph your child?
May we have permission to use your child's photograph for the purpose of promotion?
By completing this form you agree to allow NPCOB to use the above information to assist us in caring for your child during Vacation Bible School.
Please use your mouse to sign the form.
Signature
Should be Empty:

VBS Registration Form

Child Information:

Medical Information

Parent/Guardian Information:

Emergency Contact

Dismissal Information

Other Information