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 Year20102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035 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 *
