Auburn Presbyterian Church

VBS REGISTRATION

VBS REGISTRATION FORM

Child's Name
Parent's Name(s)
Address
Home Phone #
Cell Phone #
Birth Date
Email Address
Last Grade Completed
Do you go to Sunday School?	NoYes
If so, where?
Allergies, medical conditions or other info VBS staff needs to know:
Emergency Contact 1 - Name
Phone #
Emergency Contact 2 - Name
Phone #
Who can pick up this child at the end of VBS each day?
Image Verification Please enter the text from the image [ Refresh Image ] [ What's This? ]