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
*
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Child 1 Information
Child 1: Name
*
Age
*
Please select one option.
3
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12
Select Option
3
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11
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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
Select 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
Select 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
Select 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
Select 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...
Submit
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.
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