2023 VBS Registration • Mennonite Christian Assembly

First Name *

Last Name *

Date of Birth

T-Shirt Size *

School Grade Completed in 2023

Tip: If in school, please select the most recent school grade attended. Ignore Nursery and Preschool grades

VBS Class *

Tip: Select the class that you would like for your child to attend

Mailing Address *

Mailing City *

Mailing State *

Mailing Zip Code *

Emergency Contact Name *

Email Address *

Phone Number *

Mobile Number

Medical Information

Tip: Enter Medical or Allergy information that we should know about