Calvary Visalia - VBS2025Register

First Name

Last Name

Food Allergies

Yes

No

Please List Food Allergies Only

Age

Current Grade (will be during the 2025/2026 school year)

Home Church (optional)

Has your child attended Calvary Visalia VBS before?

Yes

No

Does your child have any Medical, Developmental or Allergy concerns?

Yes

No

Medical, Developmental or Allergy Concerns

Is there a friend that your child would like to be placed with?

Yes

No

Name of family/child

Add Another Child?

Yes

No

First Name

Last Name

Food Allergies

Yes

No

Please List Food Allergies Only

Age

Grade student is entering (will be during the 2025/2026 school year)

Home Church (optional)

Has your child attended Calvary Visalia VBS before?

Yes

No

Does your child have any Medical, Developmental or Allergy concerns?

Yes

No

Medical, Developmental or Allergy Concerns

Is there a friend that your child would like to be placed with?

Yes

No

Name of family/child

In the event that I cannot be reached in an emergency, by signing here, I give permission for Calvary Visalia to select a physician to hospitalize and/or secure proper treatment for my child(ren) as deemed necessary.

Full Name

Signature

By signing here, I give my permission to Calvary Visalia to post photos that include my child on the CV website and media platforms. I understand that, at any time, I can rescind my permission by sending a written request to CV.
I do this with full knowledge and consent and waive all claims for compensation for use or damages. I release Calvary Chapel of Visalia, from liability for any claims by me or any third party in connection with the use of the image of my child/children listed above.

Full Name

Signature

First Name

Last Name

Relationship to Child

Emergency Contact Phone Number

Add another emergency contact?

Yes

No

First Name

Last Name

Relationship to Child

Emergency Contact Phone Number

Add another emergency contact?

Yes

No

First Name

Last Name

Relationship to Child

Emergency Contact Phone Number

Add another emergency contact?

Yes

No

First Name

Last Name

Relationship to Child

Emergency Contact Phone Number

Add another emergency contact?

Yes

No

First Name

Last Name

Relationship to Child

Emergency Contact Phone Number

VBS Kids Registration 2025

July 14-17 | 6:30p-8:30p

Our VBS is free but if you would like to donate you can do so here

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