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 7-11Week 2 - July 14-18Child InformationNumber of Children to Register 1 2 3 Child NameDate of Birth MM slash DD slash YYYY AgeTo enroll, children must be 4-years-old on or before September 30, 2025Pre-K 3Pre-K 4Pre-K 5Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeSecond Child NameDate of Birth MM slash DD slash YYYY AgeTo enroll, children must be 4-years-old on or before September 30, 2025Pre-K 3Pre-K 4Pre-K 5Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeThird Child NameDate of Birth MM slash DD slash YYYY AgeTo enroll, children must be 4-years-old on or before September 30, 2025Pre-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.
