VBS Child Registration Form

Parent Name

Child's Name

Child's Age

Child's Sex

Male Female

Grade Your Child Will Be Entering

This address will receive a confirmation email

Phone

Would you like to receive text updates about VBS?

Yes No

Emergency Contact Name

Emergency Contact Phone Number

Does Your Child Have Any Food Allergies? If yes, please fill out the box

Does Your Child Have Any Sensory Issues? If yes, please fill out the box

Description

VBS June 9th - 13th from 6:30 - 9:00 PM!

For potty-trained 3 year olds - completed 5th grade students!