VBS Registration June 2026

Elim Romanian Church of God 1811 Arthur St, Hollywood, Fl. 33020 June 9 to 12, 2026 Time 10 a.m. - 12:30 p.m.
VBS is available for children 3 -12 years old. $25 fee per child suggested that will support a mission.
How many children are you registering?
Child Information
First Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Child Shirt Size
Medical or other information we may need to know about the child (including food allergies).
Second Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Shirt Size
Medical or other information we may need to know about the child (including food allergies).
Third Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Child Shirt Size
Medical or other information we may need to know about the child (including food allergies).
Fourth Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Child Shirt Size
Medical or other information we may need to know about the child (including food allergies).
Child Release Information
Parent/Legal Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Who may you child (children) be released to?
Emergency Contact (other than parent/guardian listed above)

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
Media and Liability Release
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.
Please note that each parent will be asked to sign a liability waiver when dropping their child off at VBS.
Should be Empty:

Elim Romanian Church of God 1811 Arthur St, Hollywood, Fl. 33020 June 9 to 12, 2026 Time 10 a.m. - 12:30 p.m.

Child Information

First Child

Second Child

Third Child

Fourth Child

Child Release Information

Media and Liability Release