FBC Daytona Beach

Family Fun in:

    VBS 2014 Registration Form

    Please answer all required questions as indicated by the red box with a asterisk.  The form will not complete and submit unless you answer the required questions.  When you are finished answering, click the "Continue" button to submit the form.  If you click the "Reset" button your form will be cleared and you will need to answer all the questions again. Thank You.

    Vacation Bible School is for kids that have just completed 5K - 5th Grade

    Parents Name
    Phone
    Address
    City
    State
    Zip
    Email Address
    First Child's Name
    First Child's Date of Birth (mm/dd/yyyy)
    First Child's Grade (Last completed)
    First Child's Allergies
    Second Child's Name
    Second Child's Date of Birth (mm/dd/yyyy)
    Second Child's Grade (last completed)
    Second Child's Allergies
    Third Child's name
    Third Child's date of birth (mm/dd/yyyy)
    Third Child's grade (last completed)
    Third child's allergies
    Pick the location to attend
    • Holly Hill
    • Daytona
    • Port Orange
    I hereby give my consent and permission for my children to attend First Baptist Church VBS as well as consent to use my child(ren)'s photograph and likeness in its publication. By selecting "YES" I attest that I am the parent or legal guardian of the child(ren) listed above.
    • Yes
    • No