VBS Registration Form 2026

Shenandoah Baptist Church VBS June 3rd - 5th 6:00 - 8:30 PM

Please fill out the registration form below with parent and child information. Read the waiver carefully and provide your electronic signature to give consent and legal acknowledgment. You will need to register each child separately.
Parent's Full Name

First NameLast Name
Parent's Email Address
example@example.com
Parent's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
What grade did your child just complete?
Will your child be needing a ride on our church bus?
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Will anyone else be picking up the child? (If yes, please give full name, phone number, and relationship to child)
I consent to my child's participation in the VBS program.
I authorize the VBS staff to seek emergency medical treatment for my child if necessary.
How did you hear about us?
Waiver

By signing this form I authorize Shenandoah Baptist Church to transport my children in the church bus or van as needed. I understand that there are potential risks in this event and do not hold Shenandoah Baptist Church or its workers responsible or liable for any accidents. In the event my child sustains an injury while attending VBS, I give permission for whatever steps may be necessary to administer first aid.
Parent/Guardian Electronic Signature
Should be Empty:

Shenandoah Baptist Church VBS June 3rd - 5th 6:00 - 8:30 PM