VBS 2023

June 19-23, 2023 | 9 AM - 12 Noon

Please fill out this form and click submit.

Parent Information

Parent's First and Last Name

*

Phone

*

Email

*

This address will receive a confirmation email

Address

*

Emergency Contact

Emergency Contact Name

*

Emergency Contact Phone

*

Child #1 Information

First Name

*

Last Name

*

Grade Going Into Fall

*

Please select one option.

PreK - 4 yrs old Kindergarten 1-2 3-4 5-6

Birthday

*

Allergies

*

Child #2 Information

First Name

Last Name

Grade Going Into Fall

Please select one option.

PreK - 4 yrs old Kindergarten 1-2 3-4 5-6

Birthday

Allergies

Child #3 Information

First Name

Last Name

Grade Going Into Fall

Please select one option.

PreK - 4 yrs old Kindergarten 1-2 3-4 5-6

Birthday

Allergies

Image Permission

I give permission for any pictures taken at VBS of my child to be used for publication from the church (slideshow, social media, in-house publications, etc.)

*

Please select all that apply.

Yes No

Description

June 19-23, 2023

9 AM - 12 Noon

Please Fix the Following

Close