Please fill out this registration form for each of your children that will be attending VBS.  After you submit the form you will receive a "Thank You" message.  Refresh your browser window and the form will reload so you can fill it out for the next child. Thank you!

Name *
Date of birth *
Date of birth
Address *
Home phone
Home phone
Cell phone
Cell phone
Emergency contact name *
Emergency contact name
Emergency contact phone number *
Emergency contact phone number