Magnified! VBS Registration

Please fill out this form and click submit.

Parent/Guardian Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Registrant #1 Name

*

Registrant #1 Age/Grade just completed

*

Please select all that apply.

Infant 3y/o-Prek Kinder 1st Grade 2nd Grade 3rd grade 4th Grade 5th Grade 6th Grade Student (7th-12th) Adult Sr. Adult Spanish Speaking Adult

Registrant #2 Name

Registrant #2 Age/Grade just completed

Please select all that apply.

Infant Toddler 3 y/o-Prek Kinder 1st 2nd 3rd 4th 5th 6th Student (7th-12th) Adult Sr. Adult Spanish Speaking Adult

Registrant #3

Registrant #3 Age/Grade just completed

Please select all that apply.

infant Toddler 3y/o-PRek Kinder 1st 2nd 3rd 4th 5th 6th Student (7th-12th) Adult Sr. Adult Spanish Speaking Adult

Emergency Contact Name and Phone number

*

If you are bringing a child, who may pick up your child besides their parent/guardian?

May we take pictures of your child for use in our slide-shows and on our social media?

*

Please select all that apply.

yes no

Please list any allergies or special needs we should be aware of.

Description

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