Kid City VBS Registration 2026

Kid City VBS Registration 2026

June 22nd -June 26
Deadline to sign up is June 15, 2026
Grace Church VBS: June 22-26

We are excited to announce VBS 2026: Kingdom Quest! Mark your calendars for June 22–26 from 6:00-8:30pm you won’t want to miss being part of this amazing week!
Child's Full Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age & Grade (2025-2026 School Year)
Potty Trained
Parent 1/Guardian 1 Full Name

First NameLast Name
Parent 1/Guardian 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent 1 /Guardian 1 Email Address
example@example.com
Parent 1/ Guardian 1 Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent 2/Guardian 2 Full Name

First NameLast Name
Parent 2/Guardian 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent 2/ Guardian 2 Email Address
example@example.com
Parent 2/ Guardian 2 Home Address (if different thank above)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Does your child have special needs?
Diagnosis
Food/drinks to avoid
Need any assistance eating/drinking
How best to assist your child with eating/drinking
Prone to seizures
What kind of seizures
In case of seizure, plan to follow
Toileting Needs
Is there any signs, gestures or words that he/she typically does indicate needing the bathroom?
Please include any support needed with toileting
Select all activities your child enjoys
What else does he/she enjoy to do?
What does he/she NOT enjoy?
Communication and Behavior Supports
Main mode(s) of communication
Behaviors that may communicate a specific need (please indicate the need where appropriate)
Is there anything that makes him/her uncomfortable with or has sensitivities to?
Behavior concerns to be aware of:
What works best to descalate situation? Any calming tools or visual aids?
Trigger points for frustration/resistance:
Is there any situations you wish to be contacted about?
Allergies/ Food Sensitivities
Please Explain
EPI Pen
Life-Threatening
Type a question
You will receive an invoice to pay through PayPal or cash at the door
T-shirt Size (purchase of t-shirt is optional)
T-Shirt Cost is $5.00 - You can give at check-in during VBS
Permission to Pick-Up child (please provide full name and phone number)
I do hereby give permission for my child to participate in VBS at Grace Church in Fairview Heights, IL that is being held June 22-26, 2026 . Furthermore, I do hereby agree that I will not hold Grace Church, its leadership, or the volunteers serving on its behalf, liable in case of accident, injury, and loss or damage of property in connection with the trip/activity. This shall include any incidents which may occur during, on the way to, or on the way from the above-stated event.

Grace Church reserves the right to take photographs or video recordings at worship services or any other church-related activities (events) and to use any of these photos or recordings for advertisement or promotional purposes in media such as, but not limited to, brochures and flyers, the church website, and online photo galleries, without seeking or requiring the consent of each person represented. If you do not wish your image to appear in these materials, please contact the church office at 618.234.5910
Parent/Guardian Signature
Should be Empty:

Kid City VBS Registration 2026

Deadline to sign up is June 15, 2026

Grace Church VBS: June 22-26

Communication and Behavior Supports