2021 VBS Alpine Ascent



Register here for VBS - Alpine Ascent at Southside Baptist Church. Registration is open to all children age 3-18. Please complete all required fields.
Parent or Guardian First and Last Name*
Email:*
Phone Number

(You may receive text message updates.)*
Address*
Alternate Contact First and Last Name
Alternate Contact Phone Number
Student 1
First and Last Name*
Student 1
Age*
Student 1
Please list any medical information we should know about your child.
Student 1
Please list any food allergies.
(Type "None" if there are no allergies.)*
Student 2
First and Last Name
Student 2
Age
Student 2
Please list any medical information we should know about your child.
Student 2
Please list any food allergies.
(Type "None" if there are no allergies.)
Student 3
First and Last Name
Student 3
Age
Student 3
Please list any medical information we should know about your child.
Student 3
Please list any food allergies.
(Type "None" if there are no allergies.)
Student 4
First and Last Name
Student 4
Age
Student 4
Please list any medical information we should know about your child.
Student 4
Please list any food allergies.
(Type "None" if there are no allergies.)
Student 5
First and Last Name
Student 5
Age
Student 5
Please list any medical information we should know about your child.
Student 5
Please list any food allergies.
(Type "None" if there are no allergies.)
Student 6
First and Last Name
Student 6
Age
Student 6
Please list any medical information we should know about your child.
Student 6
Please list any food allergies.
(Type "None" if there are no allergies.)
Will your child(ren) need picked up by a church van?
(Only available for children who do NOT require a car seat.)*
 Yes
 No
I give Southside Baptist Church permission to use pictures and/or video of my child(ren) on the church's website and/or social media accounts.*
 Yes
 No
Thank you for your registration! You will receive an email confirmation once your registration has been received.


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