VBS Registration

How many children are you signing up?

Child 1

Child's Name*

Grade*

Does your child have allergies?*

Yes
No

Allergies*

Please explain

Buddy*

Does you child have special needs requiring a buddy?

Yes
No

Please explain*

Child 2

Child's Name*

Grade*

**Allergy Student***

Yes
No

Allergies*

Please explain

Buddy*

Does you child have special needs requiring a buddy?

Yes
No

Please explain*

Child 3

Child's Name*

Grade*

**Allergy Student***

Yes
No

Allergies*

Please explain

Buddy*

Does you child have special needs requiring a buddy?

Yes
No

Please explain*

Child 4

Child's Name*

Grade*

**Allergy Student***

Yes
No

Allergies*

Please explain

Buddy*

Does you child have special needs requiring a buddy?

Yes
No

Please explain*

Child 5

Child's Name*

Grade*

**Allergy Student***

Yes
No

Allergies*

Please explain

Buddy*

Does you child have special needs requiring a buddy?

Yes
No

Please explain*

Parent & Guardian Information

Parent or Guardian 1 name*

First Last

Parent or Guardian 2 name

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

How did you hear about VBS?*

I attend EBBC
A friend/family member attends EBBC
Sign in front of the Church
East Brandywine Food Truck Festival

Consent

I agree to the privacy policy.

2023 VBS Registration

Child 1

Child 2

Child 3

Child 4

Child 5

Parent & Guardian Information

LOCATION: