VBS Registration 2009
 
 

Thank you for choosing to use our online registration form for VBS 2009, Boomerang Express. Once you submit this form, you should receive a confirmation e-mail within 2-3 business days. If you do not receive a confirmation e-mail, there has been a glitch in our form system, and we ask that you mail a copy of your printed online confirmation form to us (873 Little Neck Road, VB, 23452).

Thank you again for the opportunity to serve you and care for your children!

Ages: 4 Years Old to Grade 5
Dates: June 22-26, 2009
Theme: Boomerang Express
Time: 9:00 am - Noon

Parents: please fill out one form for all of your children.

Child 1 - Full Name Birth Date   and Age:

Allergies

 None   Food   Medicine   Other (explain food, meds & other below)

VBS Class: (check one)
4 Year Olds
Pre-K (older 4s and 5s that have not been to kindergarten)
Kindergarten (completed)
1st Grade (completed)
2nd Grade (completed)
3rd Grade (completed)
4th Grade (completed)
5th Grade (completed)
Child 2 - Full Name Birth Date   and Age:

Allergies

 None   Food   Medicine   Other (explain food, meds & other below)

VBS Class: (check one)
4 Year Olds
Pre-K (older 4s and 5s that have not been to kindergarten)
Kindergarten (completed)
1st Grade (completed)
2nd Grade (completed)
3rd Grade (completed)
4th Grade (completed)
5th Grade (completed)
Child 3 - Full Name Birth Date   and Age:

Allergies

 None   Food   Medicine   Other (explain food, meds & other below)

VBS Class: (check one)
4 Year Olds
Pre-K (older 4s and 5s that have not been to kindergarten)
Kindergarten (completed)
1st Grade (completed)
2nd Grade (completed)
3rd Grade (completed)
4th Grade (completed)
5th Grade (completed)
Child 4 - Full Name Birth Date   and Age:

Allergies

 None   Food   Medicine   Other (explain food, meds & other below)

VBS Class: (check one)
4 Year Olds
Pre-K (older 4s and 5s that have not been to kindergarten)
Kindergarten (completed)
1st Grade (completed)
2nd Grade (completed)
3rd Grade (completed)
4th Grade (completed)
5th Grade (completed)
 
Mother's Name (include last name if different)
Father's Name (include last name if different)
Home Address   ZIP
E-mail Address
 
(to verify receipt of this form)
Home Phone
 
(this stays within King's Grant Baptist)
Cell Phone
  (during VBS time, this will stay within King's Grant Baptist)
Emergency Contact Relationship
Permission to Pick Up Your Child
(other adults with permission to pick up your child)
Church You Attend?  
Member of That Church?  Yes  No
Member of Our Sunday School? (Check if Yes)
Child 1  Child 2  Child 3 Child 4 
Mother  Father
Student at King's Grant Day School? (Check if Yes) Child 1  Child 2  Child 3 Child 4 
Just a Friend from the Community? Yes  (leave unchecked if you answered "Yes" to either question above)

----- Remember to print the next page for your receipt.