VBS Registration

Welcome > Education > Summer Programs > VBS > VBS Registration

VBS dates are June 15-19, 2009, and the times are 9:00 a.m. - 12 noon each day.
Please submit one registration form per child
RED=Required Field
Child's Information - ALL FIELDS REQUIRED

Child’s First Name

Child’s Last Name

Grade Completed 

  Child’s Birthdate 

Parents’ Name(s)

Address

City

Phone

Zip

Alternate Phone

email address
Emergency Information - ALL FIELDS REQUIRED

Emergency Contact Person

Contact Phone

Medical Problems

Contact Alternate Phone

Family Doctor

Doctor Phone
Church & Family Information

Siblings Attending VBS (Names & Ages)

Child’s Denomination

Child’s Current Church Membership (if any)

Child’s Shirt Size:
Volunteer Information

I am willing to help in the following areas: (check all that apply)

 Child Care
 Registration
 Recreation
 Refreshments
 Crafts
 Decorations
 Classroom Helper

Due to a new Christian Education policy, we need to perform a background check on all volunteers working with children. So if you volunteer, please provide your birthdate

Birthdate:

I would be willing to work on the following day(s):

 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Every day!!
Person Completing this Form

Complete only if you are not the child’s parent

My Name
 Address
    Zip
  Phone

O
ther information you need to communicate with us

Please note: If after pressing submit, you do not see a “Thank You” page, your registration did not go through. You should also receive a confirmation e-mail in a day or two. If you do not, your child was not registered.
Sometimes there are glitches, so please be patient. We are sorry for any inconvenience. If you are not certain your child is registered, please call the church office (317-823-5801 x222).
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