Calvary Visalia - vbs2022

INFO@CALVARYVISALIA.ORG - (559) 687-0220

VBS Registration

*Required

Child Name

Birthday and Last Completed Grade

Food Allergies

Child Name

Birthday and Last Completed Grade

Food Allergies

Child's Name

Birthday and Last Completed Grade

Food Allergies

Child's Name

Birthday and Last Completed Grade

Food Allergies

Address 1

Address 2

City, State

Zip

Guardian Name

Guardian Email

Guardian Phone

Relationship to Child

Authorized to Pickup:

First Name

Last Name

Phone

Relationship to Child

First Name

Last Name

Phone

Relationship to Child