VBS CHILD
REGISTRATION

Child's Information

Child's First Name

Child's Last Name

Gender

Male

Female

Date of Birth

Age of Child

Does this child have any allergies?

Yes (describe below)

No

Allergy Details:

Photo Consent

Yes

No

Parent/Guardian Information

Parent/Guardian's First Name

Parent/ Guardian's Last Name

Parent/Guardian Phone Number

Email

Relationship to Child

Mailing Address

Address Line 2

City

State

Zip/Postal Code

Home Church

Emergency Contact (must be a different adult)

Emergency Contact's First Name

Emergency Contact's Last Name

Phone Number

Relation to Child

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Submit

VBS will be Monday, June 10th - Friday, June 14th from 6:00PM - 8:30PM
If you have questions please contact the church office at
(830) 217-4294
or
ministry@wilsoncountycowboychurch.com

VBS CHILD
REGISTRATION

Child's Information

Parent/Guardian Information

Emergency Contact (must be a different adult)

Wilson County Cowboy Church

Service Times

VBS CHILDREGISTRATION

Child's Information

Parent/Guardian Information

Emergency Contact (must be a different adult)

Wilson County Cowboy Church

Service Times

VBS CHILD
REGISTRATION