VBS Registration

Child's Name

Child's Gender

Male Female

Child's Age

Child's Date of Birth

Last School Grade Completed

Parent(s) Name(s)

Address

Phone

This address will receive a confirmation email

Home Church

Allergies, Medical Conditions, or Special Needs

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship to Child

Description

Please fill out this form and click submit.
Please note our classes for ages 2-5 are now full and no longer accepting registrations. If you have questions or concerns, please email Lauren at lauren@theshilohchurch.org.

VBS Registration

Description

Please Fix the Following