VBS Registration "*" indicates required fields Parent InformationParent Name(s)* Best Phone Number* Address* Street Address ZIP / Postal Code Email Contact InformationName of Contact During VBS Hours* Contact Number* Select WeekSelect ONE Of the following weeks*Week 1 - July 10-14Week 2 - July 17-21Child InformationNumber of Children to Register 1 2 3 Child Name Date of Birth MM slash DD slash YYYY Age Class to be Enrolled in (Grade Completed by June 2023):Pre-K 3Pre-K 4Pre-K 5Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeSecond Child Name Date of Birth MM slash DD slash YYYY Age Class to be Enrolled in (Grade Completed by June 2023):Pre-K 3Pre-K 4Pre-K 5Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeThird Child Name Date of Birth MM slash DD slash YYYY Age Class to be Enrolled in (Grade Completed by June 2023):Pre-K 3Pre-K 4Pre-K 5Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradePlease list known food & medication allergies, plus special medical needs of your child:Help us to verify that this form is from a real person. Week #1 July 10-14 Week #2 July 17-21 Children must be 4-years-old on-or before September 30, 2023 to enroll 9:00 AM – 12:00 Noon
