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

If another Parent/Guardian is authorized to pick-up your child, please note their full name, telephone number, and relationship to the child. For security, ID may be required at pick-up.

Payment

The cost to attend VBS all three days is $24 or $8 per day. Please select the dates student will be attending:

Student Information

Gender

Birth Date

Age Group

T-Shirt Size Youth XS Youth S Youth M Youth L Youth XL

Food Allergies

Details

Medical Concerns

Details

Photo & Media Release

Payment Instructions:

I have more students to register