2025 VBS Registration
June 9-11 6:30-8:30
Ages able to attend VBS
4 years old to ~ going into 6th grade
Student Name
*
First Name
Last Name
Age
*
Gender
*
Male
Female
Going into what grade
*
Please list any FOOD allergies
Parent/Guardian Information
Name 1
*
First Name
Last Name
Relationship
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Emergency contact number
*
Please enter a valid phone number.
Home Church Name
How did you learn about our VBS?
*
Friend
advertisement on Facebook
banner sign
Google
Other
Agreement
Would it be okay if we take photos and videos of the participant during the activity which will be posted in our social media account?
*
Yes
No
I allow my child to participate in this program or bible study during vacation time.
I authorize the church, bible study conductor, volunteer personnel to conduct first aid, and medical care in the event of an emergency situation. I agreed to pay for all the medical care expenses and costs in a given situation that medical care is needed.
I release the church from any liabilities that might happen during the activity and hold them harmless in the event of damages, injuries, or accidents.
I confirm that all information in this form is accurate and true to the best of my knowledge.
Submit
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