VBS Registration

July 24 - 29 (6pm - 8:30pm) | Please fill out one form for each child attending VBS 2022 at Kirby Baptist Church.

July 23-28 Grades Kinder through Sixth, Supper at 5:15, Bible School at 6:00-8:30

Child's Information

Name

*

Birthdate

*

Last Grade Completed

*

Please select one option.

Pre-K Kinder 1st 2nd 3rd 4th 5th 6th

Address

*

Home Church (if any):

Please list all allergies and any medical information relevant to child's time at VBS:

*

Parent/Guardian's Information

Full Name:

*

Address, if Different from Childs:

Phone

*

Email

*

This address will receive a confirmation email

Emergency Contact

1st Contact Name/Phone Number

*

2nd Contact Name/Phone Number

Dismissal Information

Name(s) of person(s) who are authorized to pick up this child from VBS:

May we photograph/video your child for publicity (no names will be used)?

*

Please select all that apply.

Yes No

Description

July 24 - 29 (6pm - 8:30pm)

Please fill out one form for each child attending VBS 2022 at Kirby Baptist Church.

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