Roblin VBS Registration

Roblin Camp VBS Registration

VBS is for children 4 to 12 years of age
VBS INFORMATION
- Monday August 17 to Friday, August 21, 2026
- VBS Runs Daily from 9:00am to 12:00pm
- VBS is for children ages 4-12
- VBS is Free to Attend. Donation are appreciated to help offset costs.
- Please email roblincamp@gmail.com with any questions.
How many children are you registering?
Child Information
First Child
Child's Name

First NameLast Name
Age
Due regulations, attendees must be over 4 years of age, we cannot accept any children under 4.
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies).
Second Child
Child's Name

First NameLast Name
Age
Due regulations, attendees must be over 4 years of age, we cannot accept any children under 4.
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies).
Third Child
Child's Name

First NameLast Name
Age
Due regulations, attendees must be over 4 years of age, we cannot accept any children under 4
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies).
Fourth Child
Child's Name

First NameLast Name
Age
Due regulations, attendees must be over 4 years of age, we cannot accept any children under 4.
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies).
Child Release Information
Parent/Legal Guardian Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daily Release

Please indicate the names of the individuals who allowed to do pickup after VBS each day, please provide at least two.
Full Name

First NameLast Name
Full Name

First NameLast Name
Full Name

First NameLast Name
Full Name

First NameLast Name
For safety and security reasons, are there any custody issues, regarding the child(ren) attending our VBS program that we should be aware of?
If yes, please explain?
Emergency Contact 1 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 1 Phone Number
Format: (000) 000-0000.
Emergency Contact 2 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 2 Phone Number
Format: (000) 000-0000.
Media Release
I hereby Give Permission for photographs and/or video in which my child appears in to be used by Roblin Wesleyan Church and/or Roblin Christian Camp in printed and/or electronic media, including the church's website.
Lunch Option At Camp Following VBS

If you would be interested in staying for lunch after VBS, please let us know how many will be joining, what ages they are, and what days.

Lunch Pricing (payed via cash at camp):
- $11.00 ages 12+
- $5.50 ages 6-12
- Free ages 0-5
Lunch Info
Please note any dietary restriction or allergies as well
Should be Empty:

Roblin Camp VBS Registration

Child Information

First Child

Second Child

Third Child

Fourth Child

Child Release Information

Daily Release

Media Release