Children's VBS Registration Please complete the following information for each child who will be attending Vacation Bible School. Child's name * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033203420352036 Allergies or Special Needs Address * City, State and Zip Code * Parent/Guardian Name Address (if different than listed above) City, State and Zip Code Home Phone Number Cell Phone Number * Email Address Driver's License Number * Emergency Contact Name, Phone Number and Relationship *
