Vacation Bible School Registration Form

Please fill out this form and click submit.

Participant First Name

*

Participant Last Name

*

Parent/Guardian Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Birthdate (must be 3 by June 1st)

*

Grade entering in fall:

*

Participant Shirt Size

*

Please select one option.

3T 4T 5T XS (2-4) SM (6-8) M (10-12) LRG (14-16) Adult SM (34-36) Adult M (38-40) Adult L (42-44) Adult XL (46-48)

Emergency Contact

*

Emergency Phone

*

Relationship

*

Alternate Pickup Name

*

Alternate Pick Up Phone

*

Alternate Pick Up Name

Alternate Pick Up Phone

Allergies:

*

Medical Conditions

*

We will post photos only, no names, from VBS on our website and social media. Please check the box only if you DO NOT give permission for us to use photos of your child.

Please select all that apply.

Do not use my child's photo.

$25 per child / payable at registration

*

Scholarships Available. Register through the church office.
admin@stthomaschesapeake.org
757 547-4662

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