VBS Registration 2019

 

Please complete the form below.

VBS program is for ages 5 yrs to 13 yrs old.

NOTE: We will require a parent to sign the waiver and release portion. This can be done on the first day of VBS or prior.

 
Parent/Guardian Name
Parent/Guardian Name
Phone
Phone
Address
Address
Parent2/Alternate Emergency Contact
Parent2/Alternate Emergency Contact
Phone
Phone
Participants
Child 1
Child 1
Birthdate
Birthdate
Child 2
Child 2
Birthdate
Birthdate
Child 3
Child 3
Birthdate
Birthdate