2026 VBS Registration
Who: Kids entering K-6th Grade; Dates: June 15th-18th, 2026; Time: 6:00-8:00 PM; Cost: suggested donation of $5 per child for supplies. Please complete one registration form per child.
General Information
Student Name
*
First Name
Last Name
Grade (Entering next school year)
*
Please Select
K
1st
2nd
3rd
4th
5th
6th
Gender
*
Please Select
Male
Female
Birth Date
*
-
Month
-
Day
Year
Date
Guardian #1 Information
*
First and Last Name
Phone Number
Guardian #2 Information
First and Last Name
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Medical/Liability Information
Allergies?
In emergencies requiring immediate medical attention, your child may be taken to the nearest hospital emergency room. Your signature below authorizes the responsible person from Harvest E-Free Church in Story City, Iowa to have your child transported to the hospital to receive treatment. If we do not have your permission, please write "no" in the signature line.
*
Photos are sometimes taken at activities for publicity and promotional purposes, which include, but are not limited to, in-house promotional presentations, church website, and church newsletters. Children's names or other personal information are never used without specific permission. By signing this area, you are releasing Harvest E-Free Church to use photos and/or videos of your child as stated above. If we do not have your permission, please write "no" in the signature line.
*
Pick up Authorization: Please list anyone, other than the guardians listed above, who have permission to pick up your child from VBS each evening.
Suggested Donation
VBS at Harvest is a free-will donation to help with the cost of materials with a recommended amount of $5 per child. Checks can be made out to Harvest E-Free Church. Please write "VBS" in the memo line. Online Payment: Scan the QR code below or use the follow link: https://www.zeffy.com/en-US/donation-form/47882a9f-4fd8-435a-ae5d-f55a0035f5a0 (please write "VBS" in the additional info. space)
Additional Information
Please write any additional information you would like us to know or questions you may have.
Contact Infomation
Please contact Harvest Children's Director, Gretchen Clapper, at gretchen.clapper@harvestefree.org with any questions!
Submit
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