VBS Registration

If you have more than 3 children please fill out and submit the form twice. Thank you.

Parents Name * First Last
Email *
Phone * - ### - ### ####
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Child 1 * First Last
Child 1 Birthdate * / MM / DD YYYY
Grade Child 1 just finished *
Child 2 First Last
Child 2 Birthdate / MM / DD YYYY
Grade Child 2 just finished
Child 3 First Last
Child 3 Birthdate / MM / DD YYYY
Grade Child 3 just finished
Please tell us where you can volunteer and help out and what days. Thank you.
Type the letters you see in the image below.