IPC ER PYPA NJ VBS REGISTRATION 2025

VBS Registration Form 2025

The India Pentecostal Church of God Eastern Region PYPA and the India Christian Assembly of New Jersey are pleased to invite you to our VBS program. This year, our theme is "Trusting Jesus In a Wild World", and we are excited to share the love of Jesus with your children. Our program will include various activities, such as biblical teachings, worship, and interactive sessions. We aim to provide your children with an unforgettable and meaningful experience that will help them in their Christian journey. Our VBS program will be held at the India Christian Assembly of New Jersey from July 1 (Tuesday) - July 3 (Thursday), from 9 AM to 4 PM. Children between the ages of 4 and 14 are welcome to attend.
Parent Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail*
example@example.com
Mobile Number*
Home Phone
Church Name*
Enter the name of the church you attend
Child #1 Information
Child #1 Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
T Shirt Size*
Select T Shirt Size
Grade in September 2025*
Allergies*

Please enter any allergies your child has. If none, please enter NONE0/500
Please let us know if your child has any special needs so we can better serve your child*

If no special needs, please enter NONE0/500
Will there be siblings attending the VBS?*

YesNo

Child #2 Information
Child #2 Name

First NameLast Name
Birth Date

MonthDayYear
Gender
T Shirt Size
Select T Shirt Size
Grade in September 2025
Allergies

Please enter any allergies your child has. If none, please enter NONE0/500
Please let us know if your child has any special needs so we can better serve your child

If no special needs, please enter NONE0/500
Do you have another sibling that you would like to register for

YesNo

Child #3 Information
Child #3 Name

First NameLast Name
Birth Date

MonthDayYear
Gender
T Shirt Size
Select T Shirt Size
Grade in September 2025
Allergies

Please enter any allergies your child has. If none, please enter NONE0/500
Please let us know if your child has any special needs so we can better serve your child

If no special needs, please enter NONE0/500

Parental Waiver and Release of Liability
Name of Parent or Legal Guardian*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
Note

Please note that once you successfully complete the registration process, you will be redirected to our Paypal donation page. While donation is not mandatory, it will be greatly appreciated and help us cover the expenses of organizing this amazing event. We believe that VBS is a crucial tool for nurturing young minds and fostering their spiritual development, and with your help, we can continue to do just that.
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VBS Registration Form 2025