VBS Registration Form Use this form to register your kid(s) for Vacation Bible School (VBS) "*" indicates required fields Parent/Guardian Name* First Last Phone*Email* How Many Kids are you registering?*Please enter a number from 1 to 4.Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home ChurchRelationship to Child*Emergency Contact* First Last Emergency Contact's Phone*Relationship to Child*I give permission to call 911 in case of emergency* YES NO Photographs will be taken during VBS. Do you give permission for your child’s photo to be taken?* YES NO Child #1Child #1 Name* First Last Child #1 Gender:* M F Child #1 DOB* MM slash DD slash YYYY Child #1 Age*Child #1 T-Shirt Size* Youth (S) Youth (M) Youth (L) List any Allergies or other medical conditionsAny special circumstances we should be aware of? (special needs or disabilities, and/or specific considerations).* YES NO Optional: Special Needs SurveyWe are excited to have your child here at VBS! We believe that every child has God given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so that we can get to know your child better.My child has the following educational label or medical diagnosis:My child’s primary means of communication is:Information concerning my child’s allergies or food sensitivities:My child’s favorite activities and interests are:My child avoids doing or becomes easily frustrated with the following activities:If my child becomes overwhelmed or frustrated they will respond best to:My child’s strengths are:My child needs help with:Suggestions to help us create the best possible experience for your child?What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?Child #2Child #2 Name* First Last Child #2 Gender:* M F Child #2 DOB* MM slash DD slash YYYY Child #2 Age*Child #2 T-Shirt Size* Youth (S) Youth (M) Youth (L) List any Allergies or other medical conditionsAny special circumstances we should be aware of? (special needs or disabilities, and/or specific considerations).* YES NO Optional: Special Needs SurveyWe are excited to have your child here at VBS! We believe that every child has God given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so that we can get to know your child better.My child has the following educational label or medical diagnosis:My child’s primary means of communication is:Information concerning my child’s allergies or food sensitivities:My child’s favorite activities and interests are:My child avoids doing or becomes easily frustrated with the following activities:If my child becomes overwhelmed or frustrated they will respond best to:My child’s strengths are:My child needs help with:Suggestions to help us create the best possible experience for your child?What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?Child #3Child #3 Name* First Last Child #3 Gender:* M F Child #3 DOB* MM slash DD slash YYYY Child #3 Age*Child #3 T-Shirt Size* Youth (S) Youth (M) Youth (L) List any Allergies or other medical conditionsAny special circumstances we should be aware of? (special needs or disabilities, and/or specific considerations).* YES NO Optional: Special Needs SurveyWe are excited to have your child here at VBS! We believe that every child has God given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so that we can get to know your child better.My child has the following educational label or medical diagnosis:My child’s primary means of communication is:Information concerning my child’s allergies or food sensitivities:My child’s favorite activities and interests are:My child avoids doing or becomes easily frustrated with the following activities:If my child becomes overwhelmed or frustrated they will respond best to:My child’s strengths are:My child needs help with:Suggestions to help us create the best possible experience for your child?What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?Child #4Child #4 Name* First Last Child #4 Gender:* M F Child #4 DOB* MM slash DD slash YYYY Child #4 Age*Child #4 T-Shirt Size* Youth (S) Youth (M) Youth (L) List any Allergies or other medical conditionsAny special circumstances we should be aware of? (special needs or disabilities, and/or specific considerations).* YES NO Optional: Special Needs SurveyWe are excited to have your child here at VBS! We believe that every child has God given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so that we can get to know your child better.My child has the following educational label or medical diagnosis:My child’s primary means of communication is:Information concerning my child’s allergies or food sensitivities:My child’s favorite activities and interests are:My child avoids doing or becomes easily frustrated with the following activities:If my child becomes overwhelmed or frustrated they will respond best to:My child’s strengths are:My child needs help with:Suggestions to help us create the best possible experience for your child?What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?
