Philadelphia Baptist Church VBS 2025 Registration Form

June 2-6, 6:00 - 8:30 PM | Please fill out this form for your 4-year-olds - 6th graders who will be attending.

Parent's Name

*

Email

*

This address will receive a confirmation email

Emergency Phone

*

Address

*

Child 1 Information

Child 1: Name

*

Age

*

Please select one option.

3 4 5 6 7 8 9 10 11 12

Any Allergies?

*

Please select one option.

Yes No

If "Yes," please list below...

Any medical restrictions?

*

Please select one option.

Yes No

If "Yes," please list below...

Child 2 Information

Child 2: Name

Age

Please select one option.

3 4 5 6 7 8 9 10 11 12

Any Allergies?

Please select one option.

Yes No

If "Yes," please list below...

Any medical restrictions?

Please select one option.

Yes No

If "Yes," please list below...

Child 3 Information

Child 3: Name

Age

Please select one option.

3 4 5 6 7 8 9 10 11 12

Any Allergies?

Please select one option.

Yes No

If "Yes," please list below...

Any medical restrictions?

Please select one option.

Yes No

If "Yes," please list below...

Child 4 Information

Child 4: Name

Age

Please select one option.

3 4 5 6 7 8 9 10 11 12

Any Allergies?

Please select one option.

Yes No

If "Yes," please list below...

Any medical restrictions?

Please select one option.

Yes No

If "Yes," please list below...

Child 5 Information

Child 5: Name

Age

Please select one option.

3 4 5 6 7 8 9 10 11 12

Any Allergies?

Please select one option.

Yes No

If "Yes," please list below...

Any medical restrictions?

Please select one option.

Yes No

If "Yes," please list below...

Description

June 2-6, 6:00 - 8:30 PM

Please fill out this form for your 4-year-olds - 6th graders who will be attending.

Please Fix the Following

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