VBS 2018 REGISTRATION
Please separately fill out one form for each child.
Child's Name
Male
Female
Date of Birth
Age
Choose one:
2
3
4
5
6
7
8
9
10
11
12
13
Grade entering in Fall:
Choose one:
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
Parent(s) Name(s)
Relationship to Child
Contact Info:
Emergency Contact
Allergies or other medical conditions
Permission to use my child's image on church media (Facebook, Website, etc.):
Yes
No
I would like to be in a group with my friend:
SUBMIT
Success! Your child is registered for Shipwrecked - Rescued by Jesus!