VBS Registration Form

WCBC VBS/Soccer Camp Registration

Widefield Community Bible Church - 702 Quebec St, Colorado Springs, 80911 - for kids 4 years old through kids who COMPLETED 6th grade
Parent/Guardian Information
Name:*

First NameLast Name
Address*

Street Address

CityState

Zip Code
E-mail
Phone Number*
Child Information
Child's Name*

First NameLast Name
Age During VBS*
Grade COMPLETED*
Gender*
Birth Date*

MonthDayYear
List allergy concerns: (If any)
List medical concerns: (If any)
Emergency Phone #:*
Emergency Contact Name:*
Who may pick up your child at the end of each VBS Day?*
How did you hear about us?*
Pictures will be taken of the children during the VBS program for a slideshow on VBS Sunday. Do we have your permission to use your child's photo?*
www.widefieldbible.org https://www.facebook.com/Widefieldbible/
Should be Empty:

WCBC VBS/Soccer Camp Registration