VBS Online Registration

Please complete a separate form for each child attending.

Child's Information

Name: first last

Birthday: Grade Completed: Choose One Not Started Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Primary Address:

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Father's Information

Name: first last

Address (if different):

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Home Phone: Work Phone:

Cell Phone:

Mother's Information

Name: first last

Address (if different):

City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Home Phone: Work Phone:

Cell Phone:

VBS Specific Information

Who is allowed to pick up your child? (specify at least one)

1. 2. 3. 4.

Emergency Contact: Phone:

Child's Allergies:

Major Medical Conditions:

Is your child enrolled in Sunday School? Choose One Yes No

If yes, church name:

VBS Class Placement: Choose One Age 4 or 5, but not beginning Kindergarte in the fall Will begin Kindergarten in the fall Just completed Kindergarten Just completed 1st Grade Just completed 2nd Grade Just completed 3rd Grade Just completed 4th Grade Just completed 5th Grade Just completed 6th Grade

Those children who have just completed the 5th and 6th grades must have a completed WABC VBS Release Form turned into the church before they can participate on the field trips.

To download a copy of the WABC VBS Release Form, click here.

Request for Transportation

Van Transportation Needed? Choose One Yes No

Who will take responsibility for the child when the child is returned home?

Please give clear directions to your home for the Van driver:

 

 

Your Email Address:

 

 

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