VBS 2022 REgistration

Child's First Name

Last Name

Child's Age

Childs Grade

Parent/Guardian Name(s)

Phone Number

Preferred Contact Method

Emergency Contact 1

Phone Number

Emergency Contact 2

Phone Number

Allergies or Special Needs

Who may pick up your child at the end of each VBS day?

First Name

Last Name

Relationship

First Name

Last Name

Relationship

May we use you childs image on our website/facebook?
Yes
No