Child's First Name *

Child's Last Name *

Parent / Guardian / Trusted Adult Name *

Parent / Guardian Phone Number(s) *

Parent / Guardian Email *

Address

Street Address

City

State

Postal Code

Child's Birthdate *

Grade Just Completed (2025-26 school year) *

Allergies or Other Medical Information we need to know *

Emergency Contact(s) - Names and Phone Numbers *

Who May Pick Up Your Child From VBS *

Does Your Child Attend Sunday School *

If yes, where?

May we have permission to photograph your child? *

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