VBS Registration

Please register your child(ren) by filling out the information below:

Parent/Guardian's First Name

Last Name

Please list Child's name, gender, Birthdate, grade

Please enter your full address:

Street Address

City

State

Zip Code

Contact info:

Email Address

Phone Number

Cell Phone Number

Home Church (Optional)

Emergency Contact in addition to previously listed parent/guardian.

Emergency Contact Number

Alton Reformed Church has permission to use photos & recordings of my child(ren)

Yes

Allergy or Medical Conditions

Are you interested in volunteering in some way at VBS

Yes

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