VBS Registration 2022

Time Lab Registration

Please complete this form to register your child for our upcoming VBS. All fields marked with an *asterisk are required. Children will not be released without a valid photo id from the parent or guardian.

Child's Name*
First Last
Gender*
Birthdate*
Date Format: MM slash DD slash YYYY
Grade Completed*
- Kindergarten
- First
- Second
- Third
- Fourth
- Fifth
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Parent or Guardian Name*
First Last
Email*
Enter Email Confirm Email
Cell Phone*
Emergency Contact Name*
First Last
Relationship to Child*
Emergency Contact Phone Number*
Name of Home Church*
Does Your Child Have Any Allergies?*
Please List
Medical Concerns*
Please List
Does this child have siblings attending VBS also
Please List Who is Authorized to Pick Up this Child*
First Last
Phone
Please List Who is Authorized to Pick Up this Child
First Last
Phone
Please List Who is Authorized to Pick Up this Child
First Last
Phone
Email
This field is for validation purposes and should be left unchanged.

Time Lab Registration

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