VBX Registration Form
VBX is open to all incoming preschool through 4th graders! It's FREE!
2022 VBX will be Sunday, July 31-Wednesday, August 3
@ Central Church 5:30pm-8:00pm

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Email *
Child's Name (first and last) *
Child's Grade Next Fall *
Required
Address
Parent/Guardian 1 Name *
Parent/Guardian 1 Phone Number *
Parent/Guardian 2 Name
Parent/ Guardian 2 Number
Additional Emergency Contact Name and Number
Food Allergy? (please list)
Special Needs?
Do you have another child to register? *
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