~ CHILD ~ Registration - Ages preschool through completed 5th Grade for Brunswick Church VBS July 6-10, 2026. 9am-12pm. Children must have been 3 by 9/1/2025.
* denotes required Field
Parent/Guardian First Name
*
Parent/Gurdian Last Name
*
Child First Name
*
Child Last Name
*
Gender
*
Male
Female
Age
*
Last Grade Completed by 7/1/26
*
Pre K
K
1
2
3
4
5
Other
Month and day of Birth MM/DD
*
Year of Birth - Must have been 3 by 9/1/25
*
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best Phone
*
Other Phone
Parent/Guardian Email
*
Home Church
Allergies or other Medical Conditions
*
Emergency Contact Name
*
Emergency Contact Phone
*
Emergency Contact Relationship
*
Comments
T-Shirt Size
*
Child Small
Child Medium
Child Large
Child Extra-Large
Adult Small
Adult Medium
Adult Large
Adult Extra-Large
Other
You have my permission and consent for my child to attend VBS, to participate in its activities, to receive emergency treatment if necessary and to allow photographs, videos, and interviews to be taken and published and used to illustrate, promote, and advertise activities at Brunswick Church. In signing below, I acknowledge that I have read and understand these instructions.
Signature Parent/Guardian
*
Submit
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