2024 VBS Scuba Registration Child's Name* Birthdate* MM slash DD slash YYYY Child's Gender*Please SelectMaleFemaleChild's Current Age* Child's T-Shirt Size*Please SelectYouth SmallYouth MediumYouth LargeAdult SmallAdult MediumLast School Grade Completed* Name of Parent(s)* Street Address* City* State*Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Home Telephone Number Parent/Caregiver's Cell Phone* If you do not have a cellphone, please enter another contact number here.Email address Home Church Allergies or other Medical Conditions* In Case of Emergency, contact:* Emergency Contact Phone Number* Relationship to Child* Δ