VBS Registration Form

To register for Vacation Bible School at Shepherd of the Coast, please complete this form. If you have any problems, call 954-772-8010. The items marked with * are required.

Child's First Name*

Child's Last Name*

Child's Age*

Grade Completed*

Parent's Name(s)*

Address

Home Phone*

Alt. Phone

Your E-mail Address*

Emergency Contact & Phone*

Food Allergies/Medical Problems*

Family Doctor

Doctor's Phone

Siblings at VBS this year

T-Shirt Size

How did you hear about us?

Submit

*Required