Vacation Bible School
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.)

If you have previously registered with us for a prior event, you can search for your stored information instead of filling out the form below.
Personal Information
*Participant's First Name:
*Participant's Last Name:
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
*Cell Phone:
(555-555-5555)
*Gender:
Email:
*Birthday:
(MM/DD/YYYY)
*What is the last grade your child completed?:






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)
*Authorized Pickup Person #1:
Authorized Pickup Person #2:
*Are you a member of UBC?:
Guest of:
*Do you attend another church other than UBC?:
If so, where?
*VBS Photo Permission:
(Do we have permission to include your child in photos during VBS week?)
*T-Shirt Size:
Comments:
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