VBX Registration




VBX will be held June 24th-June 28th

and run from 5:30pm-8:00pm in the evening

Name(s) and age(s):*
Grade Completed
Address:
Street:
City:
State:
Zip:
Phone:
Parent/Guardian Name(s)
Parent/Guardian contact information (phone/email)
In case of emergency, contact: (name and phone #)*
Will parent/guardian be helping in other areas of VBX? If yes, where?
Allergies or other medical conditions:
I grant permission for Old Fort Church to record sounds, images, or video of my child while attending "The Incredible Race". I also give permission for Old Fort Church, at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Old Fort Church in relation to "The Incredible Race".


Anything else we should know?
Enter the text you see in the security image:


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