VACATION BIBLE SCHOOL

> REGISTER HERE <

Child must be 4 by 9/1/24 to be registered!

Please register 1 child at a time

Child's Name

First Name

Last Name

Parent/Guardian Registering This Child

First Name

Last Name

Relationship To Child

Child's Gender

Age & Last Grade Completed

Birth Date

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Does Your Child Attend Sunday School Anywhere?

Medical/Other Information We Need To Know

In case of emergency, please contact:

Emer. Contact 1

First Name

Last Name

Relationship To Child

Emer. Contact 1 Phone

(###)

###

####

Emer. Contact 2

First Name

Last Name

Relationship To Child

Emer. Contact 2 Phone

(###)

###

####

Checkbox 1

Please select all that apply

Church Member

Website

Friend

Someone Invited Us

Social Media

Other

Electronic Signature Authorization

Must be signed by parent or legal guardian.