Vacation Bible School

Child's Name:*

Name Child is Called:

Gender:

Birthday:

Church Affiliation:

Grade Child is Entering:

Name of Parents:

Home Address:

City:

Zip Code:

Home Phone Number:

Email:

Mother's Work Number:

Cell Phone:

Father's Work Number:

Cell Phone:

EMERGENCY CONTACT

IN CASE OF EMERGENCY CONTACT (other than Parent)

Name:

Relationship to the Child:

Emergency Contact Number:

Cell Phone:

Can You Help?

Provide snacks for staff
Help with advance prep for VBS
Help during VBS 1 day
Help during VBS 2 days
Help during VBS 3 days
Help during VBS 4 days
Help during VBS 5 days
Help during Day Camp 1 day
Help during Day Camp 2 days
Help during Day Camp 3 days
Help during Day Camp 4 days
Help during Day Camp 5 days
Help care for infants and toddlers of VBS staff 1 day
Help care for infants and toddlers of VBS staff 2 days
Help care for infants and toddlers of VBS staff 3 days
Help care for infants and toddlers of VBS staff 4 days
Help care for infants and toddlers of VBS staff 5 days

Special Needs, Medical Conditions (including allergies), and Dietary Restrictions:

If you have a preference related to class placement (age group, with a friend, etc.):

More:

Please help us become acquainted with your child by answering a few questions about your child. Your answers will be confidential, and seen only by the VBS directors and your child’s class leader.

Is your child potty trained or newly trained?

Does your child have anything going on at home that might cause behavioral concerns, such as: a new sibling at home, recent family crisis, illness, etc?

Does your child have any behaviors that we might need to know about that might affect your child’s experience at VBS?

What is the best way to calm your child when he or she becomes upset or overly excited?

What is your child’s favorite activity at home?

Is your child a visual, auditory, or kinesthetic learner?

Tell us anything else we might like to know about your child.

Submit

* Required

Worship Times:

Office Hours:

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