VBS Sign-up 2025 August 3-5 6-7:30pm
Please fill out this form and click submit.
Child's Name
*
Name of Parents
*
Grade of school entering
*
Please select all that apply.
Age 4 Pre-School
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Email
Gender
Please select one option.
Male
Female
Phone
Address
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Emergency information
List any allergies or special needs
in case of emergency contact:
Emergency contact Phone:
Relationship to Child
Submit
Description
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