Legacy VBS Registration

Vacation Bible School will be held Wednesday, August 7- Friday August 9th from 5:00p-7:30pm

Location: Legacy International Worship Center | 2131 Wilson Ave. Pittsburgh, PA 15214

Please complete the form below

Child's Name (Required) *
Child's Name (Required)
Parent's Name (Required)
Parent's Name (Required)
Phone Number (Required)
Phone Number (Required)
Child's Birthdate (Required) *
Child's Birthdate (Required)
Who can we contact in case of an emergency?
Emergency Contact 1 Phone Number *
Emergency Contact 1 Phone Number
Please select one:
If cell phone, can we send a text?
Emergency Contact 2 Phone number
Emergency Contact 2 Phone number
Please select one:
Please list any specific allergies your child may have
Please list all medical concerns we should be aware of.