2026 Rosedale VBS Registration Form

Rosedale Gardens Presbyterian Church VBS 2026 Registration Form
July 21, 22 & 23 from 9:30 a.m. to 12 p.m.

Please fill out the below information:
Child 1 Name*

First NameLast Name
Child 1 Gender*

MaleFemale
Child 1 Age:*
Child 1 Date of Birth:*
Child 1 Grade in the Fall*
Child 1 Allergies, Medical Conditions or Special Accommodations:
Child 2 Name

First NameLast Name
Child 2 Gender

MaleFemale
Child 2 Age:
Child 2 Date of Birth:
Child 2 Grade in the Fall
Child 2 Allergies, Medical Conditions or Special Accommodations:
Child 3 Name

First NameLast Name
Child 3 Gender

MaleFemale
Child 3 Age:
Child 3 Date of Birth:
Child 3 Grade in the Fall:
Child 3 Allergies, Medical Conditions or Special Accommodations:
Name of Parent(s):*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:*

Area CodePhone Number
Parent/Caregiver's Cellphone:*

Area CodePhone Number
Home E-mail:*
Home Church:
In Case of Emergency Contact:*
Phone Number:*

Area CodePhone Number
Relationship to Child:
Request for Sibling/Friend in same group:
Individuals authorized to pick up your child from VBS:
How did you hear about our VBS program?
Photo Release

Please electronically sign the following agreement:

I understand the participants’ names with contact information may be released only to the Rosedale Gardens Presbyterian Church office. I also understand photos or videos of my child/myself, and possibly other family members, taken for church purposes, may be used for promotional purposes, including the church’s website, social media, and historical records unless indicated otherwise here:
Contact Information*

AcceptableNot Acceptable
Photo/Video*

AcceptableNot Acceptable
Parent's or Adult Participant's (over 21) Electronic Signature. Please type full name.*
Registration fee: $10 per child.

You can pay the registration fee by EITHER dropping off or mailing payment to the church (9601 Hubbard, Livonia, MI 48150) OR by using Pushpay. The link for Pushpay will be in your registration confirmation response - simply select "VBS" as the "Giving Type."
Should be Empty:

Rosedale Gardens Presbyterian Church VBS 2026 Registration Form

July 21, 22 & 23 from 9:30 a.m. to 12 p.m.