VCC Kids Guest Form
Welcome to Valley Creek Kids! We’re so glad you’re here with us today. Fill out this form below.
Step 1 of 9
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Campus
*
Denton
Flower Mound
Lewisville
Gainesville
Service Time
*
Sunday 9:30am
Sunday 11am
Tell us about yourself
*
We are a new family.
We brought a guest.
Guest of Family Information
Complete if the child is a guest of a Valley Creek family.
Full name of adult signing child(ren) in
*
First
Last
Cell phone of adult signing child(ren) in
*
Full Name of Parent/Guardian of Child(ren)
*
First
Last
Parent/Guardian Cell Phone
Parent/Guardian Information
Parent/Guardian Full Name
*
First
Last
Parent/Guardian Phone
*
Mobile Carrier
*
Please select your carrier
AT&T
Bell Mobility
Rogers Wireless
Sprint
T-Mobile
Telus
US Cellular
Verizon
AIO Wireless
Alaska Communications
Alaska Digitel
Alltel
Appalachian Wireless
Arch Wireless
Assurance Wireless
Bluegrass Cellular
C Beyond (All Page Wireless)
C Spire
C Spire (Cellular South)
Cellcom
Cellular One
Cellular One Nation
Centurytel
Chat Mobility
Chatr Mobile
Cingular
Cleartalk
Comcast PCS
Consumer Cellular
Corr Wireless
Credo
Fido
General Communications Inc.
GoPhone
H2O
iWireless
Inland Carrier
Koodo Mobile
Lyca
M1 Wireless
Manitoba Telecom Services
Mosaic Telecom
Nemont
Nex-Tech Wireless
Nextel
nTelos Wireless
Optus
Pocket
Qwest
Republic Wireless
Sasktel
Simple Mobile
Solo Bell
Solo Mobile
Southern Link Wireless
Straight Talk - AT&T
Straight Talk - Sprint PCS
Straight Talk - T-Mobile
Straight Talk - Tracfone
Straight Talk - Verizon
Telstra
TextNow.me
Ting(CDMA)
Verizon Alt.
Viaero Wireless
Virgin Mobile (Canada)
VoiceStream Wireless
Westlink
Freedom Mobile
Cellular One Illinois
MetroPCS
Centennial
Cellular South
Cincinnati Bell
Google Project Fi
Net10 Wireless
Carolina West Wireless
PC Telecom
Xfinity Mobile
Spectrum Mobile
Ting(GSM)
Family Mobile
Total Wireless
Parent/Guardian Email
*
2nd Parent/Guardian Full Name
First
Last
2nd Parent/Guardian Cell Phone
Mobile Carrier
Please select your carrier
AT&T
Bell Mobility
Rogers Wireless
Sprint
T-Mobile
Telus
US Cellular
Verizon
AIO Wireless
Alaska Communications
Alaska Digitel
Alltel
Appalachian Wireless
Arch Wireless
Assurance Wireless
Bluegrass Cellular
C Beyond (All Page Wireless)
C Spire
C Spire (Cellular South)
Cellcom
Cellular One
Cellular One Nation
Centurytel
Chat Mobility
Chatr Mobile
Cingular
Cleartalk
Comcast PCS
Consumer Cellular
Corr Wireless
Credo
Fido
General Communications Inc.
GoPhone
H2O
iWireless
Inland Carrier
Koodo Mobile
Lyca
M1 Wireless
Manitoba Telecom Services
Mosaic Telecom
Nemont
Nex-Tech Wireless
Nextel
nTelos Wireless
Optus
Pocket
Qwest
Republic Wireless
Sasktel
Simple Mobile
Solo Bell
Solo Mobile
Southern Link Wireless
Straight Talk - AT&T
Straight Talk - Sprint PCS
Straight Talk - T-Mobile
Straight Talk - Tracfone
Straight Talk - Verizon
Telstra
TextNow.me
Ting(CDMA)
Verizon Alt.
Viaero Wireless
Virgin Mobile (Canada)
VoiceStream Wireless
Westlink
Freedom Mobile
Cellular One Illinois
MetroPCS
Centennial
Cellular South
Cincinnati Bell
Google Project Fi
Net10 Wireless
Carolina West Wireless
PC Telecom
Xfinity Mobile
Spectrum Mobile
Ting(GSM)
Family Mobile
Total Wireless
2nd Parent/Guardian Email
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Child Information #1
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
Add another child?
*
Yes
No
Child Information #2
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
Add another child?
*
Yes
No
Child Information #3
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
Add another child?
*
Yes
No
Child Information #4
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
Add another child?
*
Yes
No
Child Information #5
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
Add another child?
*
Yes
No
Child Information #6
Child Full Name
*
First
Last
Child DOB (month / date / year)
*
Date Format: MM slash DD slash YYYY
Child Gender
*
Female
Male
Grade Level (If elementary school aged)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
N/A
Allergies/Special Instructions
Security Tag #
*
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