2024 VBS Registration Form

VBS 2024 Registration Form

Please fill out ONE FORM PER CHILD to register for VBS 2024 at CVBC.

Name*

Child's Gender*

Male

Female

Child's Age*

Grade Completed *

Child's Date of Birth*

Parent / Guardian Name*

Address*

Parent / Guardian Primary Phone*( ) -

Parent / Guardian Secondary Phone( ) -

Parent / Guardian Primary Email*

Do you and/or your child attend CVBC?*

Yes

Other

If you attend another church, choose other, and write the name of the church.

Allergies Or Other Medical Conditions*

if none write "none"

Emergency Contact's Name*

Emergency Contact's Phone*( ) -

Emergency Relationship to Child*

Please leave this field blank.

Need to register another child?