VBS Registration Form
July 13-17, 2026
Parent/Guardian Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
*
Format: (000) 000-0000.
E-mail
Home Church
Security Word
We understand that things come up and you may need to send someone to pick up your child(ren). For your child's safety we ask that you please make sure the person picking up your child(ren) know the security word prior to sending them for pick up.
Security Word
*
Your child will only be released when password is said correctly.
Will your family attend the Hot Dog BBQ Friday @ noon?
*
Yes
No
If yes: How many
Important Notes: Cost is $25.00 per child, with a family maximum of $80.00. How do you intend to pay? (please send e-transfers to e-transfers@npmbchurch.com password vbs2026 with a memo including your child/children's name)
*
Cash
Cheque (payable to NPMB Church)
e-transfer
Emergency contact (not a parent)
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to child
*
Please Select
Grandparent
Relative (aunt or uncle)
Family friend
Other
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Child Details:
Child Details:
Full Name
*
First Name
Last Name
Birthdate:
*
-
Month
-
Day
Year
Date
Age:
*
Please Select
2
3
4
5
6
7
8
9
10
11
12
Last grade attended:
*
Please Select
PreK
Kindergarten
1
2
3
4
5
6
Gender
*
Female
Male
Medical Care Card #
*
Special friend/crew leader request:
Does your child require any extra assistance:
*
Does your child require a gluten free/dairy free option? (choose all that apply) Please note: Children registered with either restrictions will receive only those snacks for the duration of VBS. To ensure safe food preparation, snack choices cannot be changed during the week.
*
Gluten Free
Dairy Free
No
Other allergies
If other allergies, please specify below
As part of VBS, we may take pictures of your child. May we show them (check all that apply)
*
In the Church (Print, PowerPoint)
On the Internet (Website, Facebook or Instagram)
No
A Crew photo may be taken and printed to give to each child. Do we have permission to include your child in this photo?
*
Yes
No
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Next
Child Details:
Child Details:
Full Name
First Name
Last Name
Birthdate:
-
Month
-
Day
Year
Date
Age:
Please Select
2
3
4
5
6
7
8
9
10
11
12
Last grade attended:
Please Select
PreK
Kindergarten
1
2
3
4
5
6
Gender
Female
Male
Medical Care Card #
Special friend/crew leader request:
Does your child require any extra assistance:
Does your child require a gluten free/dairy free option? (choose all that apply) Please note: Children registered with either restrictions will receive only those snacks for the duration of VBS. To ensure safe food preparation, snack choices cannot be changed during the week.
Gluten Free
Dairy Free
No
Other allergies
If other allergies, please specify below
As part of VBS, we may take pictures of your child. May we show them (check all that apply)
In the Church (Print, PowerPoint)
On the Internet (Website, Facebook or Instagram)
No
A Crew photo may be taken and printed to give to each child. Do we have permission to include your child in this photo?
Yes
No
Back
Next
Child Details:
Child Details:
Full Name
First Name
Last Name
Birthdate:
-
Month
-
Day
Year
Date
Age:
Please Select
2
3
4
5
6
7
8
9
10
11
12
Last grade attended:
Please Select
PreK
Kindergarten
1
2
3
4
5
6
Gender
Female
Male
Medical Care Card #
Special friend/crew leader request:
Does your child require any extra assistance:
Does your child require a gluten free/dairy free option? (choose all that apply) Please note: Children registered with either restrictions will receive only those snacks for the duration of VBS. To ensure safe food preparation, snack choices cannot be changed during the week.
Gluten Free
Dairy Free
No
Other allergies
If other allergies, please specify below
As part of VBS, we may take pictures of your child. May we show them (check all that apply)
In the Church (Print, PowerPoint)
On the Internet (Website, Facebook or Instagram)
No
A Crew photo may be taken and printed to give to each child. Do we have permission to include your child in this photo?
Yes
No
Back
Next
Child Details:
Full Name
First Name
Last Name
Birthdate:
-
Month
-
Day
Year
Date
Age:
Please Select
2
3
4
5
6
7
8
9
10
11
12
Last grade attended:
Please Select
PreK
Kindergarten
1
2
3
4
5
6
Gender
Female
Male
Medical Care Card #
Special friend/crew leader request:
Does your child require any extra assistance:
Does your child require a gluten free/dairy free option? (choose all that apply) Please note: Children registered with either restrictions will receive only those snacks for the duration of VBS. To ensure safe food preparation, snack choices cannot be changed during the week.
Gluten Free
Dairy Free
No
Other allergies
If other allergies, please specify below
As part of VBS, we may take pictures of your child. May we show them (check all that apply)
In the Church (Print, PowerPoint)
On the Internet (Website, Facebook or Instagram)
No
A Crew photo may be taken and printed to give to each child. Do we have permission to include your child in this photo?
Yes
No
Back
Next
Signature
*
Date
*
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: