VBS Registration Child's Name* First Last Age* Date of Birth* Month Day Year Grade Just Completed:*Select Grade Completed or Current Age of ChildPre-K or 4 yr oldsPre-K or 5 yr oldsK1st2nd3rd4th5th6th7th8th9th10th11th12thGender*BoyGirlT-Shirt Size (Select One):*Youth-X SmallYouth-SmallYouth-MediumYouth-LargeAdult-SmallAdult-MediumAdult-LargeAdult-X LargeAdult-XX LargeParent/Guardian Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Emergency Contact Information - Name, Relationship, Phone#*Does Your Child Have Allergies?* Yes No If Yes to Allergies please specifyAny special needs?Who many pick up your child at the end of VBS other than Parent or Guardian? List all names of those with permission.Name of person registering child for VBS* Email of person registering child for VBS* Do you have a church home?* Yes No If Yes, where? Share this:TweetLike this:Like Loading...