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VBS Registration 2019

Child's Name: *

Child's gender *

male

female

Date of birth *

2019-2020 school grade *

Kindergarten

1st grade

2nd grade

3rd grade

4th grade

5th grade

Name of parent(s) *

Parent phone number *

E-mail address *

Home church *

If not from West Ridge, who invited you?

Allergies or other medical conditions *

Who may pick up your child at the end of VBS each day? *

In case of emergency, contact: *

Emergency contact phone number *

T-shirt size *

Youth XSmall (4)

Youth Small (6)

Youth Medium (8)

Youth Large (10)

Youth XLarge (12)