VBS Registration is Closed!

 

Child #1 - Full Name / Age / Grade (entering this fall)*
Child #2 - Full Name / Age / Grade (entering this fall)
Child #3 - Full Name / Age / Grade (entering this fall)
Child #4 - Full Name / Age / Grade (entering this fall)
Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Cell Phone Number*
Parents Name*
Email*
I Want To Be With
Name of Home Church*
Emergency Contact Name*
Emergency Contact Number*
Medical Release:
Hospital of Choice*
Food Allergies*
Environmental Allergies*
Other Medical Conditions*
By checking "yes" below I agree to release, waive, discharge and covenant not to sue Grace Church or any of its agents for any claims on account of injury to said child.
I agree*
I give these people permission to pick up my child on these days *