First Name

Last Name

Gender

I am a volunteer under the age of 18:

Cell Phone

Email Address

Mailing Address

Mailing City

Mailing State

Zip Code

Emergency Contact Name:

Emergency Contact Phone:

Relationship:

I need Childcare during VBS for a child under the age of 2:

Child Name:

Age:

Child Name:

Age:

During VBS I would like to serve in the following areas:

If serving as a crew leader, I would prefer:

I will be there the following nights:

I will attend the following training/orientation date: (for crew leaders only)

If you would like your child(s) in your group, please list their name:

It would be best if my child(s) is not in my group. Please list their name:

I have no preference if my child is in my group or not.

I am available and willing to help vacuum and do general clean-up after VBS from 8:15 PM - done on the following nights: