Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Gender

Birth Date

Age Group

Food Allergies

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Medical Concerns

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PERMISSION TO USE IMAGES AND VIDEO: I hereby grant permission for Mount Aetna Bible Church to record sounds, images, or video of my child(ren) while attending this VBS program.

I also give permission for Mount Aetna Bible Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) in relation t

I have more students to register