Grace Bible Church What a Mess! VBS Registration Form
May 31 - June 3, 2026 6:00pm - 8:00pm
Participant Name
First Name
Last Name
Parent/Guardian Name
First Name
Last Name
Participant Age
Participant Shirt Size (Please note Youth or Adult Size- ex: Youth Medium)
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Emergency Contact Name
First Name
Last Name
Alternate Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Please list any allergies or medical conditions
I consent to my child's photo to be taken during VBS and be posted on the GBC Facebook and/or website.
Yes
No
I authorize the VBS staff to seek emergency medical treatment for my child if necessary.
Yes
No
Would your family like to receive information about Grace Bible Church services?
Yes
No
By signing this form, I agree to release and hold harmless the VBS program, staff, and volunteers from any claims or liability arising from my child's participation.
Submit
Submit
Should be Empty: