VBS Kid's Registration 2026

Parent / Guardian (Emergency Contact) *

Parent/Guardian Mobile Phone *

Parent/Guardian Email

Address *

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East Main Member / Visitor *

East Main church of Christ Member

Visitor

Please fill out separate form for each child

Child's Name *

Grade for Next School Year (Current Age for Younger Children) *

Does this child have any Food Allergies? *

Yes

Does this child have any medical conditions you feel we need to know about? *

Yes

Please use the space below to provide any information or ask any questions.