VBS Online Registration Form

Child's Name *

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Child's Name

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Child's Name

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Child's Name

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Child's Name

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Child's Name

First

Last

Age (Welcome ALL 3 year olds - rising 6th graders!)

Grade Entering

Family Information/Emergency Contacts/Transportation/Additional Information

Parent/Guardian Name *

First

Last

Home Address *

Contact Phone Number: *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number: *

Special Needs/Allergies *

Number of people attending Closing Program & Cook-Out Thursday night, including your child: *

[TRANSPORTATION REGISTRATION HAS CLOSED] Does your child need transportation (Available for 3 Years-K WITH adult & 1st - 6th Graders WITHOUT adult WITH signed Transportation Form)?

Who may pick up your child/children at the end of each VBS night? *

May we have permission to photograph your child/children? *

Do you have a home church?

If so, where?

Would you like more information about HBCC? *

Comments/Questions/Requests: