VBX Child Registration This is a form that allows parents/guardians to register their children for our Vacation Bible eXperience program. Your Name (Parent/Guardian)First and Last Name of Other Emergency Contact PersonThis is someone who can make emergency decisions regarding your children or pick them up instead of you. Their phone number during VBX times.This is someone who can make emergency decisions regarding your children or pick them up instead of you. First and Last Name of Other Emergency Contact PersonThis is someone who can make emergency decisions regarding your children or pick them up instead of you. Their phone number during VBX times.This is someone who can make emergency decisions regarding your children or pick them up instead of you. Your AddressYour Phone NumberYour E-Mail AddressYour Home Church NameFirst and Last Name of Child #1Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #1Are there any allergies or medical conditions related to Child #1 that our VBX staff should know about? What are they?First and Last Name of Child #2Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #2Are there any allergies or medical conditions related to Child #2 that our VBX staff should know about? What are they?First and Last Name of Child #3Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #3Are there any allergies or medical conditions related to Child #3 that our VBX staff should know about? What are they?First and Last Name of Child #4Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #4Are there any allergies or medical conditions related to Child #4 that our VBX staff should know about? What are they?First and Last Name of Child #5Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #5Are there any allergies or medical conditions related to Child #5 that our VBX staff should know about? What are they?First and Last Name of Child #6Their Age Group/Grade (Click One)Pre-School (Potty-Trained)Kindergarten - 2nd Grade3rd - 5th Grade6th -8th GradeThis is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #6Are there any allergies or medical conditions related to Child #6 that our VBX staff should know about? What are they?
