Register for VBS

Family Information

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Name

Student Information

Gender

Birth Date

Grade for 23-24 School Year

Age Group

Select Shirt Size

Shirt Size

Medical History

Food Allergies

Details

Medical Concerns

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Media Release By checking yes, you give Mount Pleasant Baptist Church permission to share pictures/videos via our social media (Mount Pleasant Kids and/or Mount Pleasant Facebook pages) of your child(ren).

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