2022 VBS Registration VBS 2022 Child's Registration Form One form must be filled out for each child. Child's Name* Parent/Guardian Name* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address* Same as previous Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Secondary PhoneEmail* Child's Birthday* MM slash DD slash YYYY Child's last grade completed in school* Medical Information*Medical or other information we need to know. (Please include any food allergies.) If none, type "none".Emergency Contacts (other than listed above)*Names & Phone numbers Dismissal Information*Who may pick up your child at the end of each VBS day? Does your child attend Sunday School? If so, where? If your child is visiting our church, who is he a guest of? May we have permission to photograph your child?* Yes No May we have permission to use your child’s photograph for the purpose of promotion?* Yes No NameThis field is for validation purposes and should be left unchanged. If you are intending to come to our adult class, please register here! Adult Registration
