VBX Registration

* Indicates required field

Child's Name *

First

Last

Birthdate *

(If Preschool) Year Entering Kindergarten *

(If Elementary) Grade Going Into in Fall 2023 *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian's Name *

First

Last

Parent/Guardian's Email *

Emergency Contact Number *

Allergies or Special Needs *

Do you give permission for your child's image to be included in Grace Church's Social Media posts? *

Submit

Register today!