VBS 2026

July 13th-17th

6:30PM - 8:45 PM
Ages 3-18
Child #1 Name

First NameLast Name
Child #1 Age
Please list any allergies, medical conditions, or significant information regarding this child
Child #2 Name

First NameLast Name
Child #2 Age
Please list any allergies, medical conditions, or significant information regarding this child
Child #3 Name

First NameLast Name
Child #3 Age
Please list any allergies, medical conditions, or significant information regarding this child
Child #4 Name

First NameLast Name
Child #4 Age
Please list any allergies, medical conditions, or significant information regarding this child
Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact (Other than above)
Please enter a valid phone number.Format: (000) 000-0000.
Individual(s) Authorized to pick up/drop off child(ren) with proof of ID
Home Church (If Applicable)
Informed Consent:

I hereby give permission for my child(ren) to participate in all activities prepared by Philadelphia Baptist Church (PBC) during Vacation Bible School (VBS). I assume all risks related to these activities and release PBC, its staff, volunteers, and affiliates from any liability for injuries that may occur. I also waive any claims against PBC and all associated parties in the event of such injury.
I AGREE
Confirmation:

By signing below, I am acknowledging that my electronic signature is as valid and binding as a handwritten one.
Signature
Should be Empty:

July 13th-17th

Ages 3-18

Parent/Guardian Information