VBS Online Registration Form

Below is the online VBS Registration/Emergency Contact form. You will still be required to fill out and sign the Medical Release and Consent form for each child attending. One can be downloaded here or will be provided at the church.

If you have any questions, please contact us.

Your Name (required)
Your Email (required)
Phone Number (required)

Please list each child's Name, Age, Birthdate, Last Grade Competed, and specific Food Allergies (required):

Do any of your children have medical issues, special needs or security/custody issues we need to know about? If so, please explain how we can help:

PARENT/EMERGENCY CONTACT INFO

Parent(s)/Guardian Name (required):
Address (required):
City ST Zip (required):
Home Phone:
Cell/Work Phone:
Email Address:

*In the event of an emergency, please provide us with two other people that we can call, should we be unable to reach you:

Name:
Phone:
Relationship:

Name:
Phone:
Relationship:

Please prove you are human by selecting the Key.