VBS Registration Form
Please fill out your details to register for the VBS event.
How Many Kids are you registering?
*
Please Select
1
2
3
4
5
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.
Does Enumclaw SDA Church have permission to take pictures of your child(ren) and post online?
*
Yes
No
List all names (including yourself) who is able to pick up your child(ren)
Child Information
Participant Gender - Child 1
Female
Male
Full Name - Child 1
*
First Name
Last Name
Age - Child 1
*
Date of Birth - Child 1
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Grade Completed - Child 1
Please Select
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Does the participant have any allergies or medical conditions? - Child 1
Additional Notes or Special Instructions - Child 1
Child 2 Information
Participant Gender - Child 2
Female
Male
Participant Full Name - Child 2
*
First Name
Last Name
Participant Age - Child 2
*
Participant Date of Birth - Child 2
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Grade Completed - Child 2
Please Select
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Does the participant have any allergies or medical conditions? - Child 2
Additional Notes or Special Instructions - Child 2
Child 3 Information
Participant Gender - Child 3
Female
Male
Participant Full Name - Child 3
*
First Name
Last Name
Participant Age - Child 3
*
Participant Date of Birth - Child 3
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Grade Completed - Child 3
Please Select
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Does the participant have any allergies or medical conditions? - Child 3
Additional Notes or Special Instructions - Child 3
Child 4 Information
Participant Gender - Child 4
Female
Male
Participant Full Name - Child 4
*
First Name
Last Name
Participant Age - Child 4
*
Participant Date of Birth - Child 4
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Grade Completed - Child 4
Please Select
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Does the participant have any allergies or medical conditions? - Child 4
Additional Notes or Special Instructions - Child 4
Child 5 Information
Participant Gender - Child 5
Female
Male
Participant Full Name - Child 5
*
First Name
Last Name
Participant Age - Child 5
*
Participant Date of Birth - Child 5
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Grade Completed - Child 5
Please Select
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Does the participant have any allergies or medical conditions? - Child 5
Additional Notes or Special Instructions - Child 5
Register
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