VBS Registration 1.0

VBS Registration

* Indicates required field

Child's Name *

First

Last

Birthdate *

Age *

Last Grade Level *

Gender *

T-Shirt Size *

Parent Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Second Parent Name *

First

Last

Phone Number *

Email *

Photo Release: ______________________________________ FPC VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. Choose Any *

Yes No

Emergency Contact *

First

Last

Phone Number *

Relationship *

First

Last

Emergency Contact *

First

Last

Allergies or Special Needs *

Phone Number *

Relationship *

First

Last

Submit

PAY

VBS Registration

all are loved and all are welcome!