Do not press the ENTER key until you have entered all the information in the fields below.

VBS Coordinator Mr. Zach Darrow
Email: zachgbdarrow@gmail.com
Cell: 215-767-5735

Note: Select the most appropriate class for your child below. Depending on class sizes, however, younger students who completed kindergarten may be placed in the pre-K/Kindergarten class while older ones may be placed in the Primary 1 class.

Child's Full Name:


Birth Date:


Class:


Mother's Name:


Mother's Phone:


Father's Name:


Father's Phone:


Home Address:


Email Address:


Emergency Contact Name (other than parent/guardian):


Emergency Contact Phone (parents will be called first):


Food Allergies/Medical Concerns (provide details)?


Enter VBS to ensure proper registration: