VBS Registration Form

This is our official VBS Registration form.

VBS Registration Form - June 10-14, 2019

Name of Child
Last Grade Completed
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Age of Child
Name of parent/primary caregiver
Email Address
Parent's Home Phone
Parent's Work Phone
Parent's Cell Phone
Emergency Contact - Name and Phone Number
Cost of VBS is $10 per child (waived for children attending Plymouth Preschool). By checking this box I give my child permission to participate in this program. The leader s will not be held responsible for injury, etc.
I agree
Medical Concerns/Allergies