VBS 2020 Registration Child's Name Birthday (Example 9/4/2019) Grade (As of September 2020) Grade (As of September 2020)1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade Medical - Does your child have any allergies, special needs or medical conditions? Yes or No Yes or NoYesNo If Yes please explain: Please enter your address: Street Address Address Line 2 City/State/Zip Parent / Guardian Information Parent/Guardian Name (Title, First & Last, Suffix) Phone Email Emergency Contact Name (First & Last) Phone Email Submit
