2023 Youth Rally Please fill out your child's information to register for Youth Rally. Step 1 of 9 11% How Many Children Will Be Attending?*123456 1st Child's InformationChild's Name*Child's Age or Grade*Select One6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* 2nd Child's InformationChild's Name*Child's Age or Grade*6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* 3rd Child's InformationChild's Name*Child's Age or Grade*Select One6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* 4th Child's InformationChild's Name*Child's Age or Grade*Select One6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* 5th Child's InformationChild's Name*Child's Age or Grade*Select One6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* 6th Child's InformationChild's Name*Child's Age or Grade*Select One6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeAny Known Allergies or Medical Conditions?*YesNoFor the safety of your child, please list all allergies or medical conditions.* Parent or Emergency Contact InformationName First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* How did you hear about the Flipside Youth Rally* Attend TVBC Invited by Family Member Invited by Friend Postcard Poster Advertisement Church Website Church Sign Flyer/Goodie Bag Other If other, please describe:*Permission to Attend*By typing your name below, you are consenting to your children to participate in TVBC's Vacation Bible School and all the activities involved.EmailThis field is for validation purposes and should be left unchanged. Δ
