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

I would like to receive occasional text messages regarding church updates & future events Yes No

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

I grant permission to record video & images of my child to be used on social media and in church print and online marketing Yes No

I have more students to register