VBS Registration - CC Hernando

VBS Registration Form. June 10-14th, 2019

* Indicates required field

Childs Name *

Parent/Guardian Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Work Phone Number *

Mailing Address If Different *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Childs Date of Birth *

Last Grade Completed in School *

Medical Information we need to know. (Food Allergies.) *

Who else can pick up your child at the end of VBS Day. *

Do we have permission to Photograph your child? *

May we have permission to use your child's photo for the purpose of promotion? *

Emergency Contacts (Other than listed above) *

Does Your Child Attend Sunday School? *

If Yes, Where Do They Attend Sunday school? *

If your child is visiting our church, who is he a guest of? *

Submit