VBS Registration Form

VBS 2024 Registration Form

Please note: To register more than 3 children please contact us directly at immanuel@longbranchbc.ca

Parent Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

Name & Phone Number

Child 1

Please include your child's name, birthdate, health card number, and any allergies or special needs

Child 2

Please include your child's name, birthdate, health card number, and any allergies or special needs

Child 3

Please include your child's name, birthdate, health card number, and any allergies or special needs

Legal Release

I understand that each registered child will require a signed legal release form upon drop-off on the first day of VBS.

I agree