Clone of Vacation Bible School Registration Form 2025

VBS Registration Form

June 22nd-26th, 2026 (6PM - 8PM) (2 years old - 6th grade) *PLEASE REGISTER EACH CHILD INDIVIDUALLY*
Child's Name:*

First NameLast Name
Birth Date:*

MonthDayYear
Age:*
Grade Level (going into)*
This is the grade level your child is about to go into this school year (if child is not already in or going to school, just put N/A).

Emergency Contact:*

First NameLast Name
Emergency Contact Phone:*

Area CodePhone Number
Who is Picking up Child:*
List all names of parents/guardians who are permitted to pick up your child. We will NOT release a child to anyone who is not listed here.
Special Needs / Allergies / Concerns:
Our VBS staff is trained to deal with a variety of needs and will do our best to accommodate everyone.
Parental Consent: I hereby consent to let my child participate in First Baptist Church of Memphis, NY's Vacation Bible School 2026. It is understood that every precaution will be taken for the safety and well-being of my child, but in the event of accident or sickness, First Baptist Church of Memphis, NY, its staff and its volunteers are hereby released from any liability.
Child's Name of Consent:*

First NameLast Name
Parent's Name:*

First NameLast Name
Date:

MonthDayYear
DateHourMinutesAM/PM Option
By submitting this form, I give consent to First Baptist Church of Memphis, NY of the child above
Should be Empty:

VBS Registration Form