UTBC Vacation Bible School(VBS) Student Registration Form (June 23rd-25th In-Person)
Please complete this form to register for vacation bible school.
THEME: A Fresh Move of the Spirit
Renewed. Revived. Transformed
Student name
*
First Name
Middle Name
Last Name
Birth date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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5
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31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Does the student have any siblings attending VBS?
*
Please Select
Yes
No
If no, Please skip Sibling Table Below
Please select the category that best describes the student
*
Pre-school (Age 3-5)
Primary (Age 6-8)
Juniors (Ages 9-12)
Teens (Ages 13-18)
Young Adults (Ages 19-39)
Adult (Ages 40+)
Which date will you attend VBS?
*
Tuesday, June 24th (in person)
Wednesday, June 25th (in-person)
Thursday, June 26th (in-person)
All 3 days (in-Person)
Please indicate and siblings who are attending VBS below:
Rows
First Name
Last Name
DOB
Age
Sibling #1
Sibling #2
Sibling #3
Sibling #4
Sibling #5
Parent name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home phone number
*
Format: (000) 000-0000.
Cellular phone number
*
Format: (000) 000-0000.
Student e-mail
example@example.com
Parent e-mail
*
example@example.com
Allergies/Health Conditions/ Food Restrictions
Please check category:
*
Please Select
Returning Student
First Time Student
Additional Comments
Submit Application
Clear Fields
Should be Empty: