VBS RegistrationQuestions? Please contact Sharon Trok! Please complete the form below Child's Name * First Name Last Name Child's Gender * Male Female Child's Age * 3 4 5 6 7 8 9 10 11 Date of Birth * MM DD YYYY Last School Grade Completed * K 1st 2nd 3rd 4th 5th 6th Name of Parent(s) * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone * (###) ### #### Parent/Caregiver’s Cell Phone * (###) ### #### Home Email Address * Home Church * Allergies, medical conditions, or special needs In case of emergency, contact * First Name Last Name Phone * (###) ### #### Relationship to child * T-Shirt Size Kid's X-Small Kid's Small Kid's Medium Kid's Large Kid's X-Large Thank you!
