Days Attending - Please check all that apply (Required)

Child's Name (first & last) (Required)

Child's Gender (Required)

Age (Required)

Grade Completed (Required)

Parent's Name (Required)

City (Required)

Primary Phone Number (Required)

Emergency Contact Person (Required)

Emergency Contact Phone Number (Required)

Person Responsible for Signing Child in and out of VBS and relationship (Required)

Person Responsible Phone Number (Required)

T-Shirt Size (Required)