2015 VBS Registration

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FBC Tioga VBS Registration

Last Name of Parent/Guardian *

First Name of Parent/Guardian *

Phone Number *

Best number to reach you

Street Address *

City *

State *

Zip Code *

Do you currently have a home church? *

If yes, please list

1st Child's Name *

First and Last

1st Child's Allergies?

Please list. (Snacks will be served)

1st Child's Age *

1st Child's Grade

Grade just completed, if applicable

1st Child's Birthday - Security Question *

Please enter your child's birthdate.

YYYY

2nd Child's Name

First and Last

2nd Child's Allergies?

Please list. (Snacks will be served)

2nd Child's Age

2nd Child's Grade

Grade just completed, if applicable

2nd Child's Birthday - Security Question

Please enter your child's birthdate.

YYYY

3rd Child's Name

First and Last

3rd Child's Allergies?

Please list (Snacks will be served)

3rd Child's Age

3rd Child's Grade

Grade just completed, if applicable

3rd Child's Birthdate - Security Question

Please enter your child's birthdate.

YYYY

4th Child's Name

First and Last

4th Child's Allergies?

Please list (Snacks will be served)

4th Child's Age

4th Child's Grade

Grade just completed, if applicable

4th Child's Birthday - Security Question

Please enter your child's birthdate.

YYYY

List the names and ages of any additional children attending VBS

How did you hear about us?

We are members

Website

Newspaper

Friend

Church Sign

Postcard

Other:

Clear selection

Do we have permission to include photos of your children in the daily slideshow and on our website to advertise VBS? *

Yes

Children should be picked up in the Sanctuary at 8:30 p.m. List any special arrangements that you may need for your children.

Submit

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