VBS 2021

2021 VBS Pre-Registration

Please fill out form completely. All children who plan to attend must pre-register.

If you'd like to fill out the paper form click here to download and print. Once filled out and signed, you may mail it, scan and email it, or drop it by the office.

* Indicates required field

Parent(s) Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Child's Name: *

First

Last

Child's Age: *

Child's Last Grade Completed: *

Friend to Crew with: *

Allergies/Medical Conditions of Child: *

Child's Name: *

First

Last

Child's Age: *

Child's Last Grade Completed: *

Friend to Crew with: *

Allergies/Medical Conditions of Child: *

Child's Name: *

First

Last

Child's Age: *

Child's Last Grade Completed: *

Friend to Crew with: *

Allergies/Medical Conditions of Child: *

Emergency Contact Name *

First

Last

Relationship *

Emergency Contact Phone Number *

Any additional comments or notes: *

Check Box to Grant Permission *

- By checking here and sumbitting this form, I acknowledge and grant permission for my child to be photographed.

If not giving permission for child(ren) to be photographed, please explain why. Otherwise, type 'N/A' in box below. *

Date *

I agree to receiving marketing and promotional materials

Submit

2021 VBS Pre-Registration

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