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750 San Salvador Drive Dunedin, FL 34698
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727.733.3606
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CONMY CENTER
VBS Registration K-5
Kathee Giuffré
2025-03-26T11:41:12-04:00
ABOUT VBS
ADULT VOLUNTEERS
YOUTH VOLUNTEERS
K-5 REGISTRATION
PRE-K REGISTRATION
VBS Registration K-5
June 9-13 | 9am-12pm
Grades K-5
Number of Students K-5 to be Registered
(Required)
Please enter a number from
1
to
4
.
Child Information
Child's Name
(Required)
First
Last
Grade
(Required)
Kindergarten
1st
2nd
3rd
4th
5th
2025-2026 school year
Age
(Required)
Date of Birth
(Required)
Month
Day
Year
Gender
(Required)
Female
Male
T-shirt size
(Required)
Select a size:
Youth XS
Youth S (6-8)
Youth M (8-10)
Youth L (12-14)
Adult S
Adult M
Adult L
Adult XL
Allergies or special needs?
(Required)
No
Yes
List allergies or special needs
Please list any allergies or special needs we should be aware of.
Group Preference
Please name other child(ren) with whom you would like your child to be grouped. Please note: children are not grouped by grade; we will work to keep children requested in the same large group that is together all morning.
Second Child
#2 Child's Name
(Required)
First
Last
#2 Child's Grade
(Required)
Kindergarten
1st
2nd
3rd
4th
5th
2025-2026 school year
#2 Child's Age
(Required)
#2 Child's Date of Birth
(Required)
Month
Day
Year
#2 Child's Gender
(Required)
Female
Male
#2 Child's t-shirt size
(Required)
Select a size:
Youth XS
Youth S (6-8)
Youth M (8-10)
Youth L (12-14)
Adult S
Adult M
Adult L
Adult XL
#2 Childs allergies or special needs?
(Required)
No
Yes
Allergies or Special Needs - Child #2
Please list any allergies or special needs we should be aware of.
Group Preference
Please name other child(ren) with whom you would like your child to be grouped. Please note: children are not grouped by grade; we will work to keep children requested in the same large group that is together all morning.
Third Child
#3 Child's Name
(Required)
First
Last
#3 Child's Grade
(Required)
Kindergarten
1st
2nd
3rd
4th
5th
2025-2026 school year
#3 Child's Age
(Required)
#3 Child Date of Birth
(Required)
Month
Day
Year
#3 Child's Gender
(Required)
Female
Male
#3 Child's t-shirt size
(Required)
Select a size:
Youth XS
Youth S (6-8)
Youth M (8-10)
Youth L (12-14)
Adult S
Adult M
Adult L
Adult XL
#3 Child allergies or special needs?
(Required)
No
Yes
Allergies or Special Needs - Child #3
Please list any allergies or special needs we should be aware of.
Group Preference
Please name other child(ren) with whom you would like your child to be grouped. Please note: children are not grouped by grade; we will work to keep children requested in the same large group that is together all morning.
Fourth Child
#4 Child's Name
(Required)
First
Last
#4 Child's Grade
(Required)
Kindergarten
1st
2nd
3rd
4th
5th
2025-2026 school year
#4 Child's Age
(Required)
#4 Child Date of Birth
(Required)
Month
Day
Year
#4 Child's Gender
(Required)
Female
Male
#4 Student's t-shirt size
(Required)
Select a size:
Youth XS
Youth S (6-8)
Youth M (8-10)
Youth L (12-14)
Adult S
Adult M
Adult L
Adult XL
#4 Student allergies or special needs?
(Required)
No
Yes
Allergies or Special Needs - Student #4
Please list any allergies or special needs we should be aware of.
Group Preference
Please name other child(ren) with whom you would like your child to be grouped. Please note: children are not grouped by grade; we will work to keep children requested in the same large group that is together all morning.
Parent Information
Parent's Full Name
(Required)
First
Last
Cell Phone
(Required)
Email
(Required)
Parent's Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Alternate Pickup
(Required)
First
Last
Alternate Phone
(Required)
Who is the emergency contact?
(Required)
First
Last
Relation to student
(Required)
Emergency Phone
(Required)
Photo Release
(Required)
Photos may be taken of children in groups or individually for the purpose of internal use and/or marketing, including but not limited to, our websites, social media, and printed publications.
I Agree
I Do Not Agree
Payment
Fee
Price:
Coupon Code
Total
Credit Card
(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
Security Code
Cardholder Name
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