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VBS Registration -- Who Is My Neighbor?
Ages 4 years old to completed grade 5
Monday, June 17th to Thursday, June 20th
Dinner starts at 5:30 p.m.
Program from 6:00 p.m. to 8:00 p.m.
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Email
*
Your email
Parent's Names
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Parent's Email
*
Your answer
Parent's Contact Number
*
Your answer
Full Address
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Emergency Contact
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Emergency Contact Phone #
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Child #1 Name
*
Your answer
Child #1 Age
*
Your answer
Child #1 Grade Completed in June '19
*
Choose
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child #1 Allergies or Other Concerns
Your answer
Child #2 Name
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Child #2 Age
Your answer
Child #2 Grade Completed in June '19
Choose
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child #2 Allergies or Other Concerns
Your answer
Child #3 Name
Your answer
Child #3 Age
Your answer
Child #3 Grade Completed in June '19
Choose
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child #3 Allergies or Other Concerns
Your answer
Child #4 Name
Your answer
Child #4 Age
Your answer
Child #4 Grade Completed in June '19
Choose
Pre K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child #4 Allergies or Other Concerns
Your answer
What days will you attend? Check all that apply
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Monday
Tuesday
Wednesday
Thursday
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Dietary restrictions
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None
Vegetarian
Vegan
Gluten-free
Other:
Cost is $5 per child
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Yes
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