VBS Child Registration Form 2023*

*Please note that we currently do not have any openings for VBS 2023, however, you can still sign up using the form below in order to get added to a waitlist

Child's Name *

First

Last

Child's Gender *

Child's Age *

Child's Date of Birth *

Completing Grade *

Name of Parent/Guardian *

First

Last

Street Address *

Home Phone Number *

Cell Phone Number *

Email Address

Home Church *

Special Needs/Allergies/Medical Information/Other *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Emergency Contact Relationship to Child

Dismissal Information/Name of persons who may pick up child from VBS

I give permission to use my or my child’s photo publicly to promote Cuero VBS and/or the sponsoring churches. I understand that the images may be used in print, publications, online publications, presentations, websites and social media.