VBS Registration 2025
Please fill out the form below to register for Vacation Bible School on June 24-26, 9am-11:30am.
Child's Name
*
First Name
Last Name
Age
*
Please Select
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
Grade
*
Please Select
Pre-K
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Gender
*
Male
Female
Allergies or other Medical Issues
*
Other Needs or Concerns
*
Parent's Name
*
First Name
Last Name
Contact Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to child
Submit Registration
Should be Empty: