VBS Registration Form 2024

VBS is coming! Sign up today!

June 3rd - 6th | 9:00 AM - 11:30 AM For kids entering kindergarten through 5th grade during the 2024-25 school year. Registration deadline is May 19th.

Cost is $10 per child, $40 per family maximum. Includes snacks and loads of fun for the week! Payment is due upon registering.

You can use the form to register up to 4 children. If you have more than 4 please complete the form for the first 4, and email Jenna Schutten (jennas@emcaz.org) to register your other child/ren.

1st Child

Child's Name (First & Last)

Child's Age

2024-25 Grade

Kinder 1st 2nd 3rd 4th 5th

Medical Information (Please list any medical condition we should know):

Food Allergies (or other allergies we should know):

2nd Child

Child's Name (First & Last)

Child's Age

2024-25 Grade Kinder 1st 2nd 3rd 4th 5th

Medical Information (Please list any medical condition we should know):

Food Allergies (or other allergies we should know):

3rd Child

Child's Name (First & Last)

Child's Age

2024-25 Grade Kinder 1st 2nd 3rd 4th 5th

Medical Information (Please list any medical condition we should know):

Food Allergies (or other allergies we should know):

4th Child

Child's Name (First & Last)

Child's Age

2024-25 Grade Kinder 1st 2nd 3rd 4th 5th

Medical Information (Please list any medical condition we should know):

Food Allergies (or other allergies we should know):

If you have more than 4 children please finish registering your first 4 children then email Jenna Schutten to register your other children.

jennas@emcaz.org

Parent/Guardian Information

Parent/Guardian 1 Name:

Parent/Guardian 1 Cell Phone Number:

This address will receive a confirmation email

Parent/Guardian 2 Name

Parent/Guardian 2 Cell Phone Number

Emergency Contact Information

Please list below who we should contact, after parent(s)/guardian(s) listed above, in case of emergency:

1st Emergency Contact Name

Phone

2nd Emergency Contact Name

Phone

Media/Other Information

Do we have permission to capture photos/videos of your child?

Yes No

May we have permission to use your child's photo/video image in church media?

Yes No

If anyone other than the parent(s)/guardian(s) listed above will be dropping off or picking your child, please list their information:

If you would like to help with VBS in some capacity, please check YES and we'll contact you! Yes! No

How did you hear about VBS at Estrella Mountain Church?

Payment

VBS Registration Form 2024

Description

Please Fix the Following