"Concrete & Cranes" VBS 2021

Participant Registration

If you or your child would like to participate in this event as a Participant, please complete the following form.

(If you are under 18, please have your parent or guardian complete the form.)

Personal Information

VBS is for children completing Kindergarten – 5th grade. Children age 0-5 will not be able to participate unless their parent or caretaker is a registered VBS volunteer.
*Participant's First Name:
*Participant's Last Name:
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
*Primary Phone: (555-555-5555)
*Cell Phone: (555-555-5555)
*Email:
*Gender:
*Birthday: (MM/DD/YYYY)
*Grade Completing Spring 2021:
Allergies, Medical, & Special Needs: (Leave Blank if None)
*Emergency Contact Name (1):
*Emergency Contact Phone (1): (555-555-5555)
Emergency Contact Name (2):
Emergency Contact Phone (2): (555-555-5555)
Parents: If you are picking up your child, please list yourself on the authorized pick up list.
*Authorized Pickup #1:
Authorized Pickup #2:
Authorized Pickup #3:
Authorized Pickup #4:
Do you attend Idlewild?:	Yes
--OR--
What church do you attend?:
Which of the following applies to your child?:
Does your child require a Spanish speaking class?: (Check box if you prefer a Spanish speaking class)	Yes
Would your child benefit by being in our self-contained Special Needs VBS group?
Special Needs:	Yes