Belmont VBS On-Line Signup for 2019

Parents Email (required)

Childs Name (required)

Childs Gender (required)

Childs Age (required)

Date of Birth(required)

Last school grade completed(required)

Name of Parents or Guardians(required)

Street address(required)

Home telephone(required)

Emergency contact name and number, if different than above

Home email address(required)

Do you currently attend a church?

Did this child attend Belmont VBS last year?

Would you like more information about Belmont Baptist Church?

Any allergies?

Any medical conditions?

You will receive a confirmation email after the form is completed. If you do not receive an email within 2 days, please email directly to

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