We're excited that you're interested in your child(ren) attending VBS at Eastside this year!  You can register up to 5 children that you have parental or legal guardianship of below.  Please pay special attention to line items with an asterisk (*) to the right of them......these items are required for your registration form to successfully be transmitted to our VBS leadership team.

PARENT/LEGAL GUARDIAN INFORMATION
Parents/Legal Guardian Name *
Parents/Legal Guardian Name
Main Phone Number *
Main Phone Number
Secondary Phone Number *
Secondary Phone Number
Secondary Phone Belongs to.... *
Secondary Phone Belongs to....
CHILD #1 Information
Child #1's Name *
Child #1's Name
Child #1's Birthday *
Child #1's Birthday
Child #2 Information
Child #2's Name (If Applicable)
Child #2's Name (If Applicable)
Child #2's Birthday
Child #2's Birthday
CHILD #3 INFORMATION
Child #3's Name (If Applicable)
Child #3's Name (If Applicable)
Child #3's Birthday
Child #3's Birthday
CHILD #4 INFORMATION
Child #4's Name (If Applicable)
Child #4's Name (If Applicable)
Child #4's Birthday
Child #4's Birthday
CHILD #5 INFORMATION
Child #5's Name (If Applicable)
Child #5's Name (If Applicable)
Child #5's Birthday
Child #5's Birthday
EMERGENCY CONTACT INFORMATION
Emergency Contact Name *
Emergency Contact Name
MUST BE DIFFERENT THAN PARENT/LEGAL GUARDIAN USED ABOVE.
Emergency Contact's Main Phone Number *
Emergency Contact's Main Phone Number
Emergency Contact's Secondary Phone Number (If Applicable)
Emergency Contact's Secondary Phone Number (If Applicable)
PERMISSION TO PHOTOGRAPH?
Do you give Eastside permission to photograph your child? *
NEED TRANSPORTATION?
Does your child (or children) need transportation to and/or from Eastside for VBS?