Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

I understand that I must accompany my child(ren) on the first day of VBS to sign a consent/release waiver in order for my child(ren) to attend. WAIVER

Gender

Birth Date - please include correct year

Age Group

Food Allergies

Details

Medical Concerns

Details

I have more students to register