Clone of Immanuel's VBS Registration Form

Immanuel's VBS Registration Form

July 13-16, 9:00 am to 12:00 pm; for children ages 4 years old (by January 1, 2026) through 5th Grade (completed)
Child's Name

First NameLast Name
Birth Date (must be 4 years old before January 1, 2026)

MonthDayYear
Last Grade Completed
Home Phone Number
Format: (000) 000-0000.
Mobile Number
Format: (000) 000-0000.
Email Address
example@example.com
Desired Name Tag
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide any medical or dietary restrictions you have

Immanuel's VBS Registration Form