2024 Scuba VBS Registration Child's Name * First Name Last Name Parent's Name * First Name Last Name Phone Number * Birth Date * MM DD YYYY Age * Grade Completed * Does your child have any allergies? * Medical Concerns * Emergency Contact Person * Emergency Contact Number * (###) ### #### Relationship to child * Church Affiliation * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Thank you for registering your child for VBS here at WRBC!-Pastor Jed
