Register for VBS

Family Information

Primary Phone

Alternate Phone

Address

Emergency Contact

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Authorized Pickup

USE ONE NAME PER LINE:

Parent/Guardian Automatedly Added to Authorized Pickup

Full Name, Phone # After 5:00 PM, Relationship to Child

Authorized to Pickup My Child

Student Information

Gender

Birth Date

Age Group

(Going into '25-'26 school year)

Alerts

Food Allergies

Details

Medical Concerns

Details

Acknowledgement

I Agree

I have more students to register