Kids VBS Registration

Parent/Guardian First Name

Parent/Guardian Last Name

Emergency Contact Phone Number

Alternative Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Anything else you want us to know?

Child Information

First Name

Last Name

Birthdate

Gender

Grade Just Finished

Allergies

Can we share photos of your kid(s) from VBS?

Yes

No

Signature