VBS Registration Registration Child's Name * Parent/Guardian Name * Phone Number * Email Address * Mailing Address * City * State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code * Emergency Contact * Emergency Contact Phone Number * Child's Gender * Male Female Which grade did your child just complete? * Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade T-shirt Size * If your child, has any physical limitations or food allergies, or there is other information of which we should be made aware, please describe them below: How did you hear about VBS? Do you have a home church? Yes No What is the name of your home church? If you are human, leave this field blank.