VBS Registration

Deadline to register is June 14; Cost is $20/family; must complete payment to secure registration

Parent's Information

First Name

Last Name

Phone (between the hours of 9 a.m. to 12 p.m.

(###)

###

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Which VBS dates are you signing up for?

July 22-26

Child #1 Info

First Name

Last Name

Child #1 Age

Child #1: What grade will they be entering in the fall?

Child #2 Info

First Name

Last Name

Child #2 Age

Child #2: What grade will they be entering in the fall?

Child #3 Info

First Name

Last Name

Child #3 Age

Child #3: What grade will they be entering in the fall?

Child #4 Info

First Name

Last Name

Child #4 Age

Child #4: What grade will they be entering in the fall?

Who will be picking the child up at the end of the morning?

Please list any notes for any children registered (allergies, special needs, etc)