VBS Shipwrecked
 
VBS Shipwrecked
How many children are you registering?  * 
Please use this form to register for VBS. THIS FORM DOES NOT CALCULATE YOUR TOTAL AMOUNT due for multiple children. Please do so and pay for all registered children at the end of form.
Child’s Name  * 
Child’s Age  * 
Child’s Date of Birth  * 
Last School Grade Completed (Write "NA" if Not Applicable)  * 
Name of parent(s)  * 
Street Address (Include City, State and Zip)  * 
Best Phone Number to Contact  * 
Is this number ok to text?  * 
Your Email Address  * 
Emergency Contact Name and Number  * 
Emergency contact’s relationship to child  * 
Allergies, other medical conditions or special needs of child  * 
Home Church (if none, write "none")  * 
Friends who may be attending VBS
T-Shirt Size  * 
Name of second child
TShirt Size of Second Child  * 
Second Child Age
Second Child: Last School Grade Completed (Write "NA" if Not Applicable) *
Name of third child
Third Child: Age
Third Child: Last School Grade Completed (Write "NA" if Not Applicable) *
Tshirt Size of Third Child  * 
Total cost for each additional child in family ($40 per additional child) $ 
Total $
 
 
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