2025 VBS REGISTRATION FORM... July 28 - Aug. 1 | 9 a.m. to 12 p.m.

Child's Name:

Child's Age:

Date of Birth:

Last grade completed:

Parent or Guardian:

Address:

Best phone # to reach you:

Email:

This address will receive a confirmation email

Name of person(s) authorized to pick up child:

Relationship to child:

Allergies or other medical conditions:

In case of an emergency call:

Phone:

Permission to use photo:

Yes No

Description

Please fill out this form and click submit.