WHVL VBS - Registration Form

WILD WEST - 6:30pm to 8:00pm -June 11, 12, 13, 14 2023 - VBS Registration Form

730 Willow Rd, Hendersonville, NC 28739 / WHVL.org / 828-692-6607
Child Information

Please Submit for Each Child Attending 2023 VBS at WHVL.
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Does the child attend Sunday school anywhere?*

YesNo
Where?
Medical or other information we may need to know about the child (including food allergies).*
Child Release Information
Parent/Legal Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Names of Persons to which the child (children) may be released to each night after VBS (Please provide at least two (2)*

First NameLast Name
Full Name*

First NameLast Name
Full Name

First NameLast Name
Are there any persons to which the child (children) may NOT be released to?*

YesNo
Child may NOT be released to?
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Phone Number*

Area CodePhone Number
Emergency Contact 2

First NameLast Name
Emergency Contact 2 Phone Number

Area CodePhone Number
Date Form Submitted for Registration*

MonthDayYear
Date
Media Release

Press Submit Button to Complete Registration.
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by West Hendersonville Baptist Church in printed and/or electronic media, including the church's website.*

I AgreeI Do Not Agree
Should be Empty:

WILD WEST - 6:30pm to 8:00pm -June 11, 12, 13, 14 2023 - VBS Registration Form

Child Information

Child Release Information

Media Release