VBS

Vacation Bible School

Ages 5-12
Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Last school grade completed
Name

First NameMiddle NameLast Name
Birth Date

YearMonthDay
Gender
Last school grade completed
Name

First NameMiddle NameLast Name
Birth Date

YearMonthDay
Gender
Last school grade completed
Name

First NameMiddle NameLast Name
Birth Date

YearMonthDay
Gender
Last school grade completed
Name

First NameMiddle NameLast Name
Birth Date

YearMonthDay
Gender
Last school grade completed
Parent/Family/Guardian Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Subir archivo

Cancelof
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Special Needs/Allergies/Medical Information/Other:
Emergency contact

NombreApellido
Mobile Number
Favor ingrese un número de teléfono válido.Format: (000) 000-0000.
Photo Release:

Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.
Firma

Child Registration

Per child registration fee

$25.00 Cantidad

Enter coupon

Total

Credit Card

Apple Pay

Google Pay

Cash App Pay

Vacation Bible School