Cooper River Baptist Church

VBS Registration Form 2013



This is a New VBS application

This is a correction form (Check only if you are submitting corrections to a previously submitted VBS form)

        Enter your child's name


Parent/Guardian name

  • (Physical) Address

  • Enter your child's Date of Birth (00/00/0000)


    Last grade completed


            Medical Information or other information we need to know

            (Please include any food allergies)


              Emergency Contacts



            Cell phone         

    Who may pick up your child at the end of VBS?

    Do you attend Sunday School, if so where?

    If you are visiting our church, who are you a guest of?


    May we have permission to photograph your child? Yes No

    May we have permission to use your child's photograph for the purpose of promotion? Yes No (Such as on our Church website, Newsletter, etc.)

    2012 [Cooper River Baptist Church].
    Revised: 06/19/13.