2025 VBS Registration Form

VBS is Short for Vacation Bible School.

The Theme is Rocket Racers.

All kids, Pre-Kindergarten through 6th grade are welcome!

June 2-6 from 6-8 pm at Notus Baptist Church.

We'll have games, snacks, Bible teaching and crafts.

This year's VBS will culminate in a Pinewood Derby (a race of the wood cars the kids work on during the week) and a pulled pork picknic for the whole family!
2025 VBS Registration Form
Child 1 Name

First NameLast Name
Birth Date

MonthDayYear
MaleFemale
Grade (going into)
List any allergies
Child 2 Name

First NameLast Name
Birth Date

MonthDayYear
MaleFemale
Grade (going into)
List any allergies
Child 3 Name

First NameLast Name
Birth Date

MonthDayYear
MaleFemale
Grade (going into)
List any allergies
Child 4 Name

First NameLast Name
Birth Date

MonthDayYear
MaleFemale
Grade (going into)
List any allergies
Child 5 Name

First NameLast Name
Birth Date

MonthDayYear
MaleFemale
Grade (going into)
List any allergies
Family Information
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Name*

First NameLast Name
Contact Phone Number*
Format: (000) 000-0000.
E-mail Address*
example@example.com
Yes
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
Format: (000) 000-0000.
E-mail Address
example@example.com
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Format: (000) 000-0000.
Relationship to children*
*I give consent for these authorized adults to also pick up my child(ren).
Names of people authorized to pick up children
How did you hear about our VBS?
Is there anything else we might need to be aware of before VBS starts?

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Medical Emergency Consent

A Medical Emergency is defined as:
“Circumstances in which the patient’s basic health status is immediately threatened”

In case of medical emergency, I authorize the Vacation Bible School Director or his/her designee to call the 9-1-1 system for assistance, including transportation of my child(ren) to the nearest emergency facility. I further authorize medical and/or surgical treatment for my child if necessary when I cannot be reached.
Children's names covered with this consent
Please include both first and last names
Signature

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Photo/Image Consent

As a parent/guardian of this/these child(ren), I hereby consent to the use of photographs/videotape taken during the course of Vacation Bible School for the use on the internet and/or other media sources. I do this with full knowledge and consent and waive all claims for compensation for use or for damages.
____ Yes, I give consent for Notus Baptist Church to use photographs/videos of my child(ren) for ALL website and any other social media or media purposes.____ No, I do not authorize Notus Baptist Church to use photographs/videos of my child(ren) for social media purposes.
Children's names covered with this consent
Please include both first and last names
Signature

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VBS is Short for Vacation Bible School.

The Theme is Rocket Racers.

All kids, Pre-Kindergarten through 6th grade are welcome!

June 2-6 from 6-8 pm at Notus Baptist Church.

We'll have games, snacks, Bible teaching and crafts.

This year's VBS will culminate in a Pinewood Derby (a race of the wood cars the kids work on during the week) and a pulled pork picknic for the whole family!

2025 VBS Registration Form

Family Information

Emergency Contact Information