2019 VBS Registration - Please make your check payable to MVPC with the notation VBS 2019 and mail it to MVPC, 8601 Del Webb Blvd., Las Vegas, NV 89134 Attn: Chris Kirschman. Other forms of payment are Venmo or online-giving.

June 17-21, 2019 | Please fill out this form and click submit.

I am registering

Please select one option.

My child/children My grandchild/grandchildren Other, explain below

My name and relationship to the above

Child#1 Name

Child#1 Age

Child#1 Grade (in Fall 2019)

Please select one option.

Potty-trained Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Child #1 Tee Shirt Size

Please select one option.

Youth XS Youth SM Youth MED Youth LG

Child#2 Name

Child#2 Age

Child#2 Grade (in Fall 2019)

Please select one option.

Potty-trained Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Child #2 Tee Shirt Size

Please select one option.

Youth XS Youth SM Youth MED Youth LG

Child#3 Name

Child#3 Age

Child#3 Grade (in Fall 2019)

Please select one option.

Potty-trained Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Child #3 Tee Shirt Size

Please select one option.

Youth XS Youth SM Youth MED Youth LG

Parent Name

Address

This address will receive a confirmation email

Parent Home Phone

Parent Cell Phone

Church

Friends attending VBS

Allergies

Emergency Contact

Emergency Contact Phone

2nd Emergency Contact Phone

Additional info

Payment Method

Please select all that apply.

Check Venmo On-line payment

Description

June 17-21, 2019

Please fill out this form and click submit.

2019 VBS Registration - Please make your check payable to MVPC with the notation VBS 2019 and mail it to MVPC, 8601 Del Webb Blvd., Las Vegas, NV 89134 Attn: Chris Kirschman. Other forms of payment are Venmo or online-giving.

Description

Please Fix the Following