Vacation Bible School Infant/Preschool/Kindergarten Registration Form

This form is for children of VBS volunteers who are below school age. If your child is entering Grade 1 – 6, please use the regular registration form.

Child's Name*
First Last
Gender*
Birthday*
Month
Day
Year
Child's age at the time of VBS*
- 0-2 years
- 3 years
- 4 years
- Entering Kindergarten in September 2016
Name of parent(s):*
Parent's Email
Child's Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Parent's Cell Phone
Name of Parent volunteering at VBS*
First Last
Emergency Contact (name of someone who will be available by phone during VBS hours, other than the parent who will be volunteering)*
Phone number of Emergency Contact listed above*
Home Church
Do you give permission for VBS staff to photograph your child (strictly for in-program use; photos will not be published on the Internet or social media)
- Yes
- No
If your child has any allergies or other medical conditions we should know about, please explain below:
Email
This field is for validation purposes and should be left unchanged.