The Network
power up/raise the game
VBS CHILD REGISTRATION FORM
Please fill out one form for EACH child you are registering.
Child Name
*
First Name
Last Name
Grade Just Completed
*
Kindergarten
1st
2nd
3rd
4th
5th
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Parent/Guardian Name
*
Parent/Guardian Email
Emergency Contact
*
Emergency Contact Phone
*
(###)
###
####
Please list all who are authorized to pick up your child:
*
Allergies/Special Needs:
*
Does your child have a preference as to who is in their crew?
Shirt Size:
*
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Thank you!