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 Person This 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 Person This 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 Address Your Phone Number Your E-Mail Address Your Home Church Name First and Last Name of Child #1 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #1 Are 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 #2 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #2 Are 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 #3 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #3 Are 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 #4 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #4 Are 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 #5 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #5 Are 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 #6 Their Age Group/Grade (Click One) Pre-School (Potty-Trained) Kindergarten - 2nd Grade 3rd - 5th Grade 6th -8th Grade This is the grade they will be entering in the fall of 2018.Allergies or Medical Conditions For Child #6 Are there any allergies or medical conditions related to Child #6 that our VBX staff should know about? What are they? Δ
