2025 VBS Registration - 6 Children

Please fill out this form and click submit.

Parent/Guardian Name:

*

Home Address

*

Email Address

*

This address will receive a confirmation email

Emergency Phone

*

Home Church

Child 1

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade Completed:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

Child 2

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

Child 3

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

*

Child 4

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

*

Child 5

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

*

Child 6

Child's Name:

*

Gender:

*

Please select one option.

Male Female

Age: (kids must be potty trained)

*

Please select one option.

3 4 5 6 7 8 9 10 11 12 13 14

Grade:

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Food Allergies and Medical Concerns:

*

Description

Please fill out this form and click submit.

Please Fix the Following

Close