VBS Registration

Child's First & Last Name
Grade Completed as of June 2023
Child Birth Date
Name of Parent(s) or Gaurdian
During the week we'll take pictures and videos of the children while they play and learn. Do we have permission for your child to be a part of this? We hope to present this on Friday
- Yes
- No
Email
Street Address
City, State, Zip
Home Phone
Cell Phone
Home Church if you have one.
Allergies or other medical conditions
Emergency Contact Name, Number, Relationship to Child
Submit registration

Thank you for registering. We can't wait for you to go on this adventure with us!

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Christian Assembly