WHVL VBS - Registration Form

Food Truck Blast - 6:30pm to 8:00pm June 12, 13, 14, 15 2022 - VBS Registration Form

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

Please Submit for Each Child Attending 2022 VBS at WHVL.
Child's Name *

First Name Last Name
Child's Birth Date *

Month Day Year
Last Grade Completed *
Does the child attend Sunday school anywhere? *

Yes No
Where?
Medical or other information we may need to know about the child (including food allergies). *
Child Release Information
Parent/Legal Guardian Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State

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 Name Last Name
Full Name *

First Name Last Name
Full Name

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

Yes No
Child may NOT be released to?
Emergency Contact 1 *

First Name Last Name
Emergency Contact 1 Phone Number *

Area Code Phone Number
Emergency Contact 2

First Name Last Name
Emergency Contact 2 Phone Number

Area Code Phone Number
Date Form Submitted for Registration *

Month Day Year
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 Agree I Do Not Agree
Should be Empty:

Food Truck Blast - 6:30pm to 8:00pm June 12, 13, 14, 15 2022 - VBS Registration Form

Child Information

Child Release Information

Media Release