Child Information

Please fill in the boxes below. Anything with a star icon next to it is required.

Child's First Name

Child's Last Name

Age

Grade (Just Finished)

Gender

Allergies

VBS Attendance

Using the check boxes below, please indicate which nights you plan for your child to attend:

VBS: Start the Party Nights

Night 1 - June 4

Night 2 - June 11

Night 3 - June 18

Night 4 - June 25

Parent or Guardian Information

Please fill in the boxes below. Anything with a star icon next to it is required.

Parent's First Name

Parent's Last Name

Phone Number

Email

Relation to Child

Feedback

If there is anything else you would like to share with us, you may use the space provided below to input any questions, comments, or concerns you may have.

Questions, Comments, or Concerns