The Assembly West Monroe - vbsregistration

VBS Registration

July 10th - 13th | 5:30-8:30PM | Grades K-5th

Parents Name

Last Name

Email Address

Phone Number

Address 1

Address 2

Country

City

State

Zip/Postal Code

Checkboxes
Member of The Assembly?

Name of Child

Last Name

Grade completed

T-shirt Size

Any Allergies?

Name of Child

Last Name

Grade Completed

T-shirt Size

Any Allergies?

Name of Child

Last Name

Grade Completed

T-shirt Size

Any Allergies?

Name of Child

Last Name

Grade Completed

T-shirt Size

Any Allergies?

Anything else you'd like to share?