VBS Registration

• • Parents'/Guardian's Names*
    First Name

    Last Name
  • First Name

    Last Name
  • Your E-mail*
     
  • Address*
    Street Address*

    Address Line 2

    City*

    Province / State / Region*

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country*
  • Phone Number*
     

    (###)

    -

    ###

    -

    ####
  • Phone Number-Work
     

    (###)

    -

    ###

    -

    ####
  • Emergency Contact*
    First Name

    Last Name
  • Phone Number
     

    (###)

    -

    ###

    -

    ####
  • Relationship to Child(ren)
  • Emergency Contact
    First Name

    Last Name
  • Phone Number
     

    (###)

    -

    ###

    -

    ####
  • Relationship to Child(ren)
  • Who else may sign child(ren) out of camp (besides parent/guardian)
    First Name

    Last Name
  • First Name

    Last Name
  • Do you give consent to take your child's photo and use it on social media for advertising purposes?*
    Yes

    Yes, but only if face is not showing

    No, please don't post anything with my child's photo and use it on social media
  • 1st Child's Information*
    First Name

    Last Name
  • Date of Birth*
    MM

    DD

    YYYY
  • Age *
  • Register additional children
    Yes

    No
  • 2nd Child's Information
    First Name

    Last Name
  • Date of Birth
    MM

    DD

    YYYY
  • Age *
  • 3rd Child's Information
    First Name

    Last Name
  • Date of Birth
    MM

    DD

    YYYY
  • Age *
  • 4th Child's Information
    First Name

    Last Name
  • Date of Birth
    MM

    DD

    YYYY
  • Age *
  • Does your child/children have any developmental/physical/behavioural challenges/needs that we should be made aware of?
    Please specify which child and issues
  • At VBS we serve nut-free snacks. Does your child/children have any food allergies that we should be aware of?
    Please specify which child and specific allergies
• 
  Submit