West Church, Peabody, MA
Vacation Bible School - July 8 - 12, 2019
Registration Form

VBS Registration is now closed.

* indicates required field
Parent Information
Parent or Guardian Name -- First: *    Last: *
Street Address:
City:    State:    ZIP:
Email Address:
Home Phone:
Mobile Phone:
Person to Notify in Case of Emergency: *
Their immediate contact phone #: *
Church Affliation (optional):

From time to time, during VBS we may take photos of the children learning, playing and having fun!
Check here if you do not want photos of your child(ren) to be featured on our website.

Child Information
Child Name -- First: *    Last: *
Birth Date:
Grade: * Those going into Kindergarten, or are 4-years old, please register in the Pre-K Class.
Kindergarten through grade six will register in the class they were in at school this past year.
Does this child have allergies
or other medical conditions?
Please list:
Is there a classmate your child wishes to be placed with?
Shirt Size: We would like to give your child a free VBS T-shirt. Please indicate your child's size.