Register for VBS

Family Information

Address

Primary Phone

Secondary Phone

Please enter any alternate adults authorized to pick up your child.

Alt. Pickup Phone #

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Gender

Birth Date

Please select the grade your child just finished:

Age Group

Food Allergies

Details

Medical Concerns

Details

I have more students to register