VBC 2018

Register for VBC 2018 - you can register up to three children at a time.

First Child

* Indicates required field

Child's Name *

First

Last

Birthday *

Date *

Year *

Grade in September 2018 *

Again this year, on of our rotations for the week will be by choice. Please select the top two choices for each child. "Games" is an option choice but will also be included in the regular rotation for all children.

Top pick: *

Second Choice *

Allergies or other medical conditions *

Second Child

Child's Name *

First

Last

Birthday *

Date *

Year *

Grade in September 2018 *

Top pick *

Second choice *

Allergies or other medical conditions *

Third Child

Child's Name *

First

Last

Birthday *

Date *

Year *

Grade in September 2018 *

Top pick *

Second choice *

Allergies or other medical conditions *

Parent/Guardian's Name *

First

Last

In case of emergency, please contact *

Street Address *

City *

Home Phone Number *

Cell Phone *

Photography Consent *

Email *

Would you like to receive our monthly newsletter? *

Yes please! No thank you. I already do, thanks!

Name of home church, if any *

Submit

Registration is $10 per child to a maximum of $20 per family. Payment is due on the first day of camp. Thank you!