Cactusville VBS Registration

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Step 1 of 3

Mother First Name

Mother Last Name

Father First Name

Father Last Name

Primary Email

Home Phone

Cell Phone

Address

City

State

ZIP

Home Church

Who to contact in emergency?

Special Needs / Accommodations
Check this if any child requires special accommodations. This will add an additional survey step.

Medical Release: I authorize VBS staff to administer basic first aid and contact emergency services if needed.

Digital Signature (Type your name)

Photo Release: I grant permission for photos/videos of my children to be used in church media.

Digital Signature

Custody arrangements we should be aware of?

Volunteer: I am interested in volunteering to help with VBS!

Manage Registration

Thank you for registering for Cactusville VBS.