VBS 2021 Participant Registration

July 18th-21st (6-8:30) | Please fill out this form and click submit.

Parent/Guardian

Please list the name and information of the primary emergency contact and pick up person in the first section and add an additional pickup person/contact below.

Parent/Guardian Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Secondary Contact/Pick-Up Name

Secondary Contact/Pick-Up Phone

Participant

You will need to complete one registration form for each participant you're registering. We apologize for any inconvenience this might present.

Name

*

Gender

*

Please select one option.

Male Female

Birthdate

*

Grade Completed/Age

*

Please select one option.

3 yrs 4 yrs 5 yrs (has not gone to Kindergarten yet) K 1st 2nd 3rd 4th 5th 6th 7th 8th

T-Shirt Orders are closed, but if you're interested in buying a t-shirt, check with someone at registration to see if we have any extras! ($12 due on July 19th)

Please select all that apply.

Allergies

Comments/Notes

Description

July 18th-21st (6-8:30)

Please fill out this form and click submit.

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