2024 VBS Child Registration

Registration Available for Ages 3-11yrs old

Child #1

First Name

Last Name

Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Gender

Phone Number

Parent Information

Parent/Guardian First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Emergency Contact

First Name

Last Name

Email

Phone Number

Medical Conditions and Allergies

Does your Child have any allergies or medical conditions?

Yes

No

If you answered yes, please list any allergies, medical conditions and medications

Order a VBS Shirt for your Child

Child #1 : Select your child's t-shirt size

Photo Release

Cowboys for Jesus Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Signature

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