Riverside VBS Pre-Registration

Register your child by filling out the information below:

Child's Name

Child's Age

Food allergies or other medical conditions

Parent/Guardian contact info:

Parent or Guardian's Name

Email Address

Phone Number

What is the best way to reach you?

Email

Phone

Emergency Contact (name and phone)

Who is authorized to pick up your child?

Please enter your full address:

Street Address/City/State/Zip Code

How did you hear about us?

Does your family currently have a regular church home? If so, which?

Additional Information (any special needs should also be brought to our attention at sign-in)

Thank You. Your child has been registered!