Vacation Bible School 2022

July 18-22
9 - 11:45 AM
473 Merrimac Trail, Williamsburg
For rising K-5th graders

VBS Registration

Parent/Guardian Information

Parent/Guardian Name*

Address*

Phone*( ) -

Emergency Contact Name (during VBS hours)*

Emergency Contact Phone*( ) -

Child Information

Child 1

Please fill out the information for your child.

Child's Name*

Date of Birth*

School grade as of September 2022*

T-shirt Size*

Please note we will do our best to accommodate size preference.

Allergies/Health Concerns

Child 2

Please fill out the information for your child.

Child's Name

Date of Birth

School grade as of September 2022

T-shirt Size

Please note we will do our best to accommodate size preference.

Allergies/Health Concerns

Child 3

Please fill out the information for your child.

Child's Name

Date of Birth

School grade as of September 2022

T-shirt Size

Please note we will do our best to accommodate size preference.

Allergies/Health Concerns

Child 4

Please fill out the information for your child.

Child's Name

Date of Birth

School grade as of September 2022

T-shirt Size

Please note we will do our best to accommodate size preference.

Allergies/Health Concerns

Media Release & Electronic Signature

Media Release*

I do give my permission for Eastside Church to use my child’s/children's photograph (without their name) in EC publications, on the web, and in emailed newsletters.

I do not give my permission for Eastside Church to use my child’s/children's photograph (without their name) in EC publications, on the web, and in emailed newsletters.

Registration Verification*

By checking this box, I acknowledge that this serves as my electronic signature for the above registration and media release.

Please leave this field blank.