Westside Baptist Church

Vacation Bible School Registration

• • Child's Name*
    First Name

    Last Name
  • Child's Birthdate*
    MM

    DD

    YYYY
  • Grade Child Enters in the Fall*
    >KindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth Grade
  • Allergies/Medical Information
    Any information we need to know to keep your child healthy
  • Street Address*
  • City/State/Zip*
  • Parent/Guardian*
    First Name

    Last Name
  • Your E-mail
     
  • Best Contact # during VBS*
    This should be the best contact number for Parent/Guardian
     

    (###)

    -

    ###

    -

    ####
  • OK to TEXT?*
    YES

    NO
  • Emergency Contact*
    Who should we should contact if parent/guardian cannot be reached?
    First Name

    Last Name
  • Emergency Contact's Phone Number*
     

    (###)

    -

    ###

    -

    ####
  • OK to TEXT?
    YES

    NO
  • Person responsible for picking up child (if other than any listed above)
    First Name

    Last Name
  • Phone Number
     

    (###)

    -

    ###

    -

    ####
  • OK to TEXT?
    YES

    NO
• 
  Submit