VBS 2021 Registration Form Date: August 9 - 13, 2021 Time: 7:00 p.m. nightly (Virtual Experience) PERSONAL INFORMATION Adult #1 Name Invalid Input Birth Month/Year (optional) Invalid Input Email Address(*) Invalid Input Adult #2 Name Invalid Input Birth Month/Year (optional) Invalid Input Email Address Invalid Input Adult #3 Name Invalid Input Birth Month/Year (optional) Invalid Input Email Address Invalid Input Minor Child(ren) Child #1 Name Invalid Input Birth Month/Year Invalid Input Last School Grade Invalid Input Child #2 Name Invalid Input Birth Month/Year Invalid Input Last School Grade Invalid Input Child #3, Name Invalid Input Birth Month/Year Invalid Input Last School Grade Invalid Input Child #4, Name Invalid Input Birth Month/Year Invalid Input Last School Grade Invalid Input OTHER INFORMATION Do you and/or your child attend Sunday School? ( Select One) YesNo Invalid Input If yes, where? Invalid Input Are you and/or your child a member of any church? (Select One) YesNo Invalid Input If yes, where? Invalid Input If you are visting MCBC, whose guest are you? Invalid Input Do we have permission to photograph you and/or your child for promotional purposes? (Select One) YesNo Invalid Input Comments Invalid Input (*) Invalid Input