VBS Registration Student Information Name Of Student * First Name Last Name Date Of Birth * MM DD YYYY Grade Completed * 6th Grade (Middle School) 7th Grade (Middle School) 8th Grade (Middle School) 9th Grade (Freshman) 10th Grade (Sophmore) 11th Grade (Junior) 12th Grade (Senior) Parent/Gaurdian Information Address Address 1 Address 2 City State/Province Zip/Postal Code Country Parent/Guardian Name * First Name Last Name Parent/Guardian Phone * (###) ### #### Email Questions? Comments? Concerns? Thank you!