Vacation Bible School Registration 2024

June 3-7 | 9:00AM - Noon

Child Information

Child's Name

Grade Completed

Age

Child's Name

Grade Completed

Age

Child's Name

Grade Completed

Age

(Please note children must be age 3 by June 1 and toilet trained to attend.)

Parent and Contact Information

Parents' names

Home address (Members of Redeemer may skip this question)

Primary phone

Alternate phone

Contact Email Address

Emergency Contact Information

Emergency contact person

Phone

Relationship to child

Health Information

Food Allergies

List

Medical or other concerns

List

Church Information

Church affiliation

Church membership at

Additional Information

Please list the adults who will be picking up children

Attendance (days)

VBS leaders have permission to photograph/film the minor (s) designated above in any manner or form for any lawful purpose associated with this VBS program.

Verification to update your information with Redeemer's records.

You must verify before submitting.