Vacation Bible School Registration Form

Vacation Bible School Registration Form

Please complete a form for each child attending
CHRIST CHURCH EPISCOPAL
PARENT/GUARDIAN NAME(S):
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Name

First NameLast Name
Secondary Email
example@example.com
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
STUDENT INFORMATION
Name

First NameLast Name
Birth Date

MonthDayYear
Date
Grade in Fall 2026
Have you previously attended VBS?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Church (if any)
Siblings Enrolled in VBS
EMERGENCY CONTACTS
Primary Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
Alternate Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
Okay to pick up from VBS?
Alternate Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
Okay to pick up from VBS?
Medical Information
Please list all allergies -- or type "none" if there are none
Please list all medical concerns or special needs-- or type "none" if there are none
Does your child carry an epi-pen? (please note: if yes, it is the responsibilty of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)
Additional Information
VBS photos/videos are taken for promotional purposes related to Christ Church and Vacation Bible School. These pictures appear in various media outlets such as The News and our facebook page and webpage. Do you allow your child to be included in these photos/videos?
Interested in volunteering?
Preferred Contact Method
By submitting this form, I ackowledge I have read and understand the above information.
Signature
Should be Empty:

Vacation Bible School Registration Form

Medical Information

Additional Information