vbs test form – New Vision

VBS Registration Test Form

Child's Name*
First Last
Child Gender*
T-Shirt Size*
Child Date of Birth*
MM slash DD slash YYYY
Grade*
What grade category is your child in? (select only 1)
Want to add more Kids?
Child's Name 2*
First Last
Child Gender of 2*
T-Shirt Size for Child 2*
Child 2 Date of Birth*
MM slash DD slash YYYY
Grade for child 2*
What grade category is your child in? (select only 1)
Child's Name 3*
First Last
Child Gender of 3*
T-Shirt Size for Child 3*
Child 3 Date of Birth*
MM slash DD slash YYYY
Grade for child 3*
What grade category is your child in? (select only 1)
Child's Name 4*
First Last
Child Gender of 4*
T-Shirt Size for Child 4*
Child 4 Date of Birth*
MM slash DD slash YYYY
Grade for child 4*
What grade category is your child in? (select only 1)
Child's Name 5*
First Last
Child Gender of 5*
T-Shirt Size for Child 5*
Child 5 Date of Birth*
MM slash DD slash YYYY
Grade for child 5*
What grade category is your child in? (select only 1)
Parent/Guardian Name*
First Last
Address*
Street Address City ZIP / Postal Code
Home or Cell Phone #*
Work Phone #
E-Mail Address*
What's the best email address we should use to reach you?
Child's Allergies/Medical Conditions
Medical Release*
I, the parent/guardian of the child listed above, give permission to the VBS leadership to authorize or administer medical attention to my child if they deem it an emergency during VBS Club activities. I understand every effort will be made to contact me first or as quickly as possible. To "sign" this release, please enter your First and Last name in the field here.
In the event of an emergency, please list who we should contact and their phone numbers.*

If we can't get in touch with you or your spouse, please list individuals (and their phone numbers) we should call.
After VBS, my child may be released to the following people:*

Please enter names below other than mother or father. Enter any special notes.
VBS Program Fee*
Price:
Vacation Bible School program fee per child.
VBS Program Fee*
Price:
Vacation Bible School program fee per child.
VBS Program Fee*
Price:
Vacation Bible School program fee per child.
VBS Program Fee*
Price:
Vacation Bible School program fee per child.
VBS Program Fee*
Price:
Vacation Bible School program fee per child.