VBS 2024 Registration

Child's Name (required)

Parent's Name (required)

Email (required)

Address (required)

Primary Phone (required)

Alternate phone number

Child's Age (required)

Grade Completed (required)
—Please choose an option—N/AK51st2nd3rd4th5th6th

Child's Birthday (required)

Allergies/Medical Information
None

Emergency Phone (required)

Home Church

Would You Like to Request Bus Transportation? (required)
YesNo