VBS Registration 2018
 
VBS Registration 2018
Registration fees for VBS 2018 are $25 for the first child in a family; $20 for each additional child. VBS is for children 4 years to rising 5th grade.
*Early Registration Discount! Register before July 1st for only $20.00 for the first child and $15.00 for siblings!
Child's First Name  * 
Child's Last Name  * 
Parent/Caregiver Name/s  * 
Age of Child (as of July 8)  * 
Gender of Child  * 
Grade for 2018-2019  * 
Date of Birth  * 
Child's T-Shirt Size (T-Shirts are included in the Registration Fee and come in Youth XS through Adult 4XL)  * 
Address  * 
Best Parent Phone  * 
Other Phone  * 
Best Parent Email  * 
Home Church
Does your child have allergies, physical limitations, or other conditions that may affect their participation? If so, please elaborate.
Is your child on medications we should know about? Please list with schedule and instructions if necessary.
EMERGENCY INFORMATION
Emergency Contact: Name (parent/guardian)  * 
Emergency Contact: Relation to Child  * 
Emergency Contact: Phone  * 
Additional Emergency Contact: Name  * 
Additional Emergency Contact: Relation to Child  * 
Additional Emergency Contact: Phone  * 
If you want only certain individuals to be permitted to pick up your child, please list with contact numbers:
Please list any individuals you DO NOT want to pick up your child:
MEDICAL INFORMATION
Preferred Physician, Name  * 
Preferred physician, phone  * 
Preferred Hospital/s  * 
Medical Insurance: Name of Provider  * 
Medical Insurance: Policy #  * 
PHOTO RELEASE. We may use a limited number of VBS photos on our church website or in church publications. Your child's name would never be used in conjunction with their photo.  * 
************* ADDITIONAL CHILD ("Child 2") *************
To register a sibling, continue with their information here. If this does not apply, skip to the "Additional Purchases or Fees" section.
[Child 2] First Name (preferred name)
[Child 2] Last Name
[Child 2] Age of Child (as of July 8)
[Child 2] Gender of Child
[Child 2] Grade for 2018-2019
[Child 2] Date of Birth
[Child 2] Child's T-Shirt Size (T-Shirts are included in the Registration Fee and come in Youth XS through Adult 4XL)
[Child 2] Does your child have allergies, physical limitations, or other conditions that may affect their participation? If so, please elaborate.
[Child 2] Is your child on medications we should know about? Please list with schedule and instructions if necessary.
[Child 2] Is there family, emergency or medical information about this additional child that is different than the above?
If multiple siblings are registered for VBS (grades pre-3rd), should they be placed in the same tribe?
************* 2ND ADDITIONAL CHILD ("Child 3") *************
To register a second sibling, continue with their information here. If this does not apply, skip to the "Additional Purchases or Fees" section.
[Child 3] First Name (preferred name)
[Child 3] Last Name
[Child 3] Age of Child (as of July 8)
[Child 3] Gender of Child
[Child 3] Grade of Child, 2018-2019
[Child 3] Date of Birth
[Child 3] Does your child have allergies, physical limitations, or other conditions that may affect their participation? If so, please elaborate.
[Child 3] Child's T-Shirt Size (T-Shirts are included in the Registration Fee and come in Youth XS through Adult 4XL)
[Child 3] Is your child on medications we should know about? Please list with schedule and instructions if necessary.
[Child 3] Is there family, emergency or medical information about this additional child that is different than the above?
ADDITIONAL PURCHASES OR FEES
Are you interested in a VBS music CD for pick-up on the first night? Cost: $6.99 (Must be submitted by June 25)
Additional Sibling Registration Fees (before July 1)  * 
Any other information we should know?
Please review our Child Protection Policy as (found at www.lakesidechurch.org under "Learn") and discuss the Child Code of Conduct with your child.
Your Email Address  * 
Base Price $
Modifications $
Total $
 
 
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