VBS

Complete the form below to register your child for VBS. Form is not complete until the "Submit" button is clicked. We request one form per child.

I live in Palmdale, and would like my child to be picked up. *

Yes

* Indicates required field

Childs Name *

First

Last

Birthday *

Address *

Parent Name *

First

Last

Phone Number *

Email *

Parent Name *

First

Last

Phone Number *

Email *

In addition to the parents, the following people are authorized to pick my child up. (please note, unless a name is on this form, we will not release your child to an individual *

Allergies *

Is there any other info you wish to communicate to our VBS staff? *

I understand that all workers at the Mountain View Bible Church have been background checked pursuant to PA law. In addition, I authorize my child to participate in all games and activities of Mountain View Bible Church. I will not hold Mountain View liable to any injury my child may sustain in the course of activities and events. I understand that several staff members are trained in first aid and CPR and authorize treatment if needed. *

Yes

Submit