Hanoverdale VBS 2021

Fill out this form to register for VBS. You can register up to 4 children per form entry. We ask that you fill out all requested information for each child listed. Please fill out the form again if you need to register additional students. Contact our office with any questions (office@hanoverdale.church).

Child 1 (First and Last Name)

*

Child's Gender

*

Please select one option.

M F

Child's Age

*

Child's Date of Birth

*

Last School Grade Completed

*

Please select one option.

3yrs (potty trained)-pre-k K 1st 2nd 3rd 4th 5th

Allergies, Medical Conditions, or Other Notes

(Optional) Would like to be in the same group as...

Child 2 (First and Last Name)

Child's Gender

Please select one option.

M F

Child's Age

Child's Date of Birth

Last School Grade Completed

Please select one option.

3yrs (potty trained)-pre-k K 1st 2nd 3rd 4th 5th

Allergies, Medical Condition or Other Notes

(Optional) Would like to be in the same group as...

Child 3 (First and Last Name)

Child's Gender

Please select one option.

M F

Child's Age

Child's Date of Birth

Last School Grade Completed

Please select one option.

3yrs (potty trained)-pre-k K 1st 2nd 3rd 4th 5th

Allergies, Medical Conditions, or Other Notes

(Optional) Would like to be in the same group as...

Child 4 (First and Last Name)

Child's Gender

Please select one option.

M F

Child's Age

Child's Date of Birth

Last School Grade Completed

Please select one option.

3yrs (potty trained)-pre-k K 1st 2nd 3rd 4th 5th

Allergies, Medical Conditions, or Other Notes

(Optional) Would like to be in the same group as...

Parent or Guardian

*

Relationship to Child

*

Can be used as:

Please select all that apply.

Emergency Contact Pickup

Email

This address will receive a confirmation email

Primary Phone

*

Secondary Phone

Address

*

Home Church

*

Parent or Guardian 2

Relationship to Child

Can be used as:

Please select all that apply.

Emergency Contact Pickup

Email

Phone

Address

Additional Parent/ Guardian/ Pickup People (Please include first and last name, contact info, and relationship to child)

Additional Notes or Questions

Description

Fill out this form to register for VBS. You can register up to 4 children per form entry. We ask that you fill out all requested information for each child listed. Please fill out the form again if you need to register additional students. Contact our office with any questions (office@hanoverdale.church).

Please Fix the Following

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