Southside Christian - VBS Registration

This is the first time children from our family have attended VBS at Southside Christian Church.

We attended VBS at Southside last year! Welcome back!

Family Information

Family Last Name

Home Phone

Address

City

State

Zip

Name of Emergency Contact

Emergency Contact Phone #

Physician's Name

Physician's Phone Number

Person(s) authorized to pick your children up from VBS
(Jr. High kids will be released without parent pick up.)

Any special pick up concerns

If your child plans to walk home each day,
please indicate this decision hereYesNo

Parent Information

Father's Last Name

Father's First Name

Work or Cellular Phone

Will be volunteering at VBS? If yes, be sure to fill out the volunteer information in the next step. YesNo

Mother's Last Name

Mother's First Name

Work or Cellular Phone

Will be volunteering at VBS?
If yes, be sure to fill out the volunteer information in the next step.YesNo