Boomerang Express

VBS Online Registration

Registering for Vacation Bible School is easy with our online registration form. Simply fill in the form below and click "Submit Registration Form ". Please make sure that all information is correct prior to submitting forms. Only one form is required per family. Form fields with and asterisk (*) are required. Please accompany children to the check in desk on the first day as a signature from a parent or legal guardian will be required to complete the registration.

VBS is FREE and open to all children age 4 (as of June 29th) thru completion of 5th grade.

Thank you for your cooperation.

Northside Baptist
VBS Online Registration form
2009
Parent/Guardian information

Parent 1 Name(*):

Parent 2 Name:

Address(*):

City(*):

Zip(*):

Home Church:

How did you hear about VBS?:

Home Phone(*):

Work Phone:

Cell Phone:

Email(*):

Can we take your child(ren)'s picture?: Yes No

Who may pick up your child(ren) at the end of each day?(*):

 
Emergency Contact Information

Name(*):

 Phone(*):
1st Child Information

Name(*):

Birthdate(dd/mm/yyyy)(*):

Age(*):

Last grade completed(*):

 Medical or other information we need to know (please include any food allergies):
2nd Child Information

Name:

Birthdate(dd/mm/yyyy):

Age:

Last grade completed:

 Medical or other information we need to know (please include any food allergies):
3rd Child Information

Name:

Birthdate(dd/mm/yyyy):

Age:

Last grade completed:

 Medical or other information we need to know (please include any food allergies):
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Northside Baptist Church - 7965 Oswego Rd. - Liverpool, NY 13090 - (315) 652.3160
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