Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

May we put your child/ren's photo on the church's website?

How did you hear about us?

If "other", please explain

Details

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

List allergies, if there are any.

Does your child have any SEVERE allergies? (ex. bee stings, food, penicillin, other medications ...)

Details

If yes, please check the box and explain what the allergy is, and add any additional information which would be helpful for us.

Does your child have any LIFE-THREATENING allergies?

Details

If yes, please check the box, note what the allergy is, and add any additional information which would be helpful for us.

Medical Concerns

Details

If there are any medical concerns, please check the box, and then explain them in the text box which will pop up..

Does your child have any physical, emotional, mental or behavioural concerns that our staff should be aware of, which will help us to make your child comfortable and more effectively teach him/her?

Details

If yes, please check the box, and explain. (For example, learning disabilites ...)

Is your child bringing any medication whith him/her (ex. antibiotics, inhaler, epipen). If yes, please check the box, and detail the medication in the text box which will appear.

Details

I have more students to register