VBS Registration Form

Child's Full Name (required)

Parent's Name (required)

Your Email (required)

Parent's Phone Number (required)

Parent's Street Address (required)

Parent's City & Zip (required)

Second Contact Person (required)

Second Contact's Phone Number (required)

Child's Age (required)

Child's Grade in the fall (required)

Siblings/Friends at VBS (required)

I give permission to use my child's pictures on church affiliated social media:

I attend a different church:

I attend Smyser CC:

Child's t-shirt size:

Allergies (if any)

Any additional information you would like to provide