VBS Registration

Ages 3 to entering 5th Grade

You can register up to two children with each submission

Child's Name (last name first)

Child's age

Child is entering grade

Allergies (if any)

Child's Name (last name first)

Child's age

Child is entering grade

Allergies if any

Parent's Name (last name first)

Your Email (required)

Phone Number (required)

Emergency Contact Name and phone (in case you can not be reached)

Alternate Emergency Contact Name and Phone

Who will be picking the child up? (please provide all names)

Church affiliation
St. ThomasOtherNone

Any additional information you would like to provide