Registration Form

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VBS Participant Registration Form ~ages 4 through 5th grade~ GRADE COMPLETED

If you are volunteering and you have a 2 or 3 year old that will be coming to VBS, please fill out this form. 2 and 3 year old VBS crews are for parent volunteers only.

Child’s name:

______________ M

F

Age:_____

Street address: City: Home telephone: (

___State: )

Zip: Cell phone: (

)

__________

Home e-mail address: ___________________________________________________________ Date of Birth:

Last grade completed:

If your child would like to order a VBS T-Shirt or Music CD, the cost is $10.00 each. Items must be paid for at the church or online before they can be ordered. Deadline to order and pay is June 4th. T-Shirt: YES NO

Size: YXS YS YM YL YXL AS AM AL AXL

Music CD: YES NO Total Owed: _____ Total Paid: _____ In case of emergency, contact: Mother:

_____ Father:

Other:

Allergies or other medical conditions: _____________________________________________________________________________ Home church: MAKER FUN FACTORY Crew Number (church use only):________________________________