VBS Registration

Please complete a separate form for each child attending VBS.

VBS Registration 2019

VBS Registration 2019

Last name, first name
MM/DD/YYYY
Number & Street Name
Apartment Number if appropriate
Grade completed as of end of school year.
Gender*
Provide: Name, relationship, and phone number if different from mother or father.
Does child have any allergies?*
List any conditions that staff may need to be aware of to ensure the safety and well being of your child.
Authorization for Release*
As a parent or guardian, I give permission for my child's picture to be taken while participating in activities at Westway Baptist Church. By checking Yes, I also authorize their pictures to be published to Westway's web page.
MM/DD/YYYY