March 12, 2019March 13, 2019 by Alison Oh

2019 VBS Online Registration

6/18 (Tue) ~ 6/21 (Fri)
30 Months Old ~ 4th Grade

Name *

First

Last

Age *

Date of Birth *//

Last School Grade Completed (2018-19): *

Name of Parent/Guardian *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Church

Allergies or other medical conditions

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Emergency Contact Relationship to Child

Names and Grade of Siblings

Please submit the application to complete the VBS registration and make a $30 payment at Church Everyday.
Thank you!

Name