Register for VBS

Family Information

Address

Primary 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

Gender

Birth Date

Last Grade Completed

Age Group

Food Allergies

Details

Medical Concerns

Details

Does this child need a ride on the church van?

If yes, please provide the pick-up/drop-off address

T-shirt size

Who is allowed to pick up this child each day?

I have more students to register