VBS 2026 Registration
Please fill out this form and click submit.
Child(ren) Name
*
Parent/Guardian Name
*
Address
*
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Email
*
This address will receive a confirmation email
Phone
*
Date of Birth
*
Last School Grade Completed
*
Emergency Contact #1
*
Emergency Contact Phone Number #1
*
Emergency Contact #2
*
Emergency Contact Phone Number #2
*
Will need transportation by van? (Children have to be 5 years & older to ride van)
*
Please select all that apply.
Yes
No
Who is allowed to pick up this child from VBS?
*
May we have permission to photograph your child? (Photos may be used for social media and website promotion)
*
Please select all that apply.
Yes
No
I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency. I release anyone affiliated with New Town Baptist Church from liability in case of an accident during activities or transport to/from activities as long as normal safety procedures have been taken.
*
Please select one option.
Yes
No
Submit
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