VBS Registration Form

We are glad to announce that registration for VBS is open! Please fill out the form below to register your child for Vacation Bible School!

Questions for VBS Registration Form

1.

Student Name

The answer should be a text input.
2.

Birth Date

The answer should be a date input.
3.

Gender

The answer should be a single choice:
  1. Male
  2. Female
  3. Others
4.

Grade completed

The answer should be a number input.
5.

Have you previously attended VBS?

The answer should be a single choice:
  1. Yes
  2. No
6.

Home Church

The answer should be a text input.
7.

Street Address

The answer should be a text input.
8.

City

The answer should be a text input.
9.

State

The answer should be a text input.
10.

Country

The answer should be a country.
11.

Zipcode

The answer should be a number input.
12.

Phone Number

The answer should be a phone number.
13.

Primary Guardian

Name

The answer should be a text input.
14.

Relationship to child

The answer should be a text input.
15.

Please list all allergies or type "none" if there are none

The answer should be a text input.
16.

Does your child carry an epi-pen? (please note: if yes, it is the responsibility of the child's guardian to ensure the child has the epi-pen at every drop-off and pick up)

The answer should be a single choice:
  1. Yes
  2. No
17.

Please list all medical concerns or type "none" if there are none

The answer should be a text input.
18.

Please list the names of any other children (friends or family) that you would like placed in the same class as this child

The answer should be a text input.
19.

VBS photos/videos are taken for promotional purposes related to St. Andrew's Presbyterian Church and Vacation Bible School. These pictures appear in various media outlets such as The Ancaster News and our Facebook page and webpage. Do you allow your child to be included in these photos/videos?

The answer should be a single choice:
  1. Yes
  2. No

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