Register for VBS

Family Information

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

T Shirt (additonal $10) Yes No

T-shirt size ------ 6 8 10 12 14 16

I give consent for my child's photo to be taken.

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

I have more students to register