VBS 2023

July 17-21, 2023

Registration Form

Name of Parent/Guardian Completing Form *

First

Last

Email *

Contact Number *

Emergency Contact Number If You Cannot Be Reached *

Address *

Child's Name and Birthdate *

Grade Completed *

Please List All Current Allergies, Medications or Food Restrictions *

Do you currently attend church and if so, where? *

Comments or Questions