Parents Name:
Phone Number:
E
mail:
Address:
City:
State
Child's Name
Child's Age
303 North 5th St. Chandler, IN 47610 (812) 925 6954
Please use the Form below to
register for VBS.
Every child that is preregistered
will receive 5 VBS Bucks upon
arrival at VBS.
Pre-Register by July 1st for 10
VBS Bucks!