VBS Signup Form

VBS 2023

Child's First & Last Name & Age

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Home Church Name & City

My Children have my permission to attend on the following nights:

July 23rd

July 24th

July 25th

July 26th

In case of questions or an emergency, I can be reached at this phone number:

Parents First Name

Parents Last Name

Email Address:

Special instruction concerning transportation:

Special instructions concerning health issues:

Special instructions concerning other issues:

I heard about CBC's VBS from: (if applicable)

By typing my name in this box, I understand this is legally my signature:

Today's Date