VBS Online Registration Form June 18, 2017June 18, 2017 Child's Name Birth Date Grade Completed Age Address City State Zip Code Mother's/Guardian's Name Phone During VBS time Father's/Guardian's Name Home Phone Email address Home church (if any) Doctor's name Phone Allergies/Medical Issues/Special Instructions Person(s) authorized to pick up child Emergency contact if parent/guardian can't be reached: Relationship Phone Signature of Parent or Guardian Date VBS Location Attending (Please Select Location) Alton July 9-13 Godfrey July 16-20 Submit Δ Share this:EmailPrintFacebookTwitterLike this:Like Loading...
Upper Alton Baptist Church 