VBS 2023

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2023 VBS Registration (Ages 5-11)

1Child(ren) Info

2Regsitration Info

How many children would you like to register?(Required)

Child 1

Name(Required)

First Last

Date of Birth(Required)

Grade Fall 2023(Required)

Allergies or other concerns?

Child 2

Date of Birth(Required)

Grade Fall 2023(Required)

Allergies or other concerns?

Child 3

Date of Birth(Required)

Grade Fall 2023(Required)

Allergies or other concerns?

Child 4

Date of Birth(Required)

Grade Fall 2023(Required)

Allergies or other concerns?

Parent / Guardian Name(Required)

First Last

Address(Required)

Street Address City Province Postal Code

Phone(Required)

Alt Phone

Email(Required)

Your Church

I would like more information about

Hillside Church

Emergency Contact

Name

First Last

Relationship to Child(Required)

Phone(Required)

Alt Phone