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Participant Registration

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Registro en Español

Erlanger Baptist Church

Location

116 Commonwealth Avenue

Erlanger, KY 41018

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Contact Adam Townsend:

859-727-2588

erlangerbaptistchurch@gmail.com

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Email will be used for VBS communication purposes.

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Please do not put yourself as the emergency contact if possible.

Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Home Church Affiliation

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Tell Us About Your Participant

First Name

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Last Name

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When selecting "Grade Leaving", note that nursery is for volunteer children only (Ages 0-2). All VBS participants must be at least 3 at the time VBS starts.

Grade Leaving

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Comments

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