2026 VBS Registration Form

2026 VBS Registration Form

Register each child
Student Name

First NameLast Name
Group
Age
Date of Birth

MonthDayYear
Date
Gender
Grade Completed
T-Shirt Size
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Parent Name

First NameLast Name
Relationship
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
Emergency Contact

First NameLast Name
Relationship
Emergency Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized person who can pickup the child on dismissal

First NameLast Name
Relationship
Pickup Person Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate authorized person who can pickup the child on dismissal

First NameLast Name
Relationship
Alternate Pickup Person Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Special Needs / Allergies - Please enter NA if none
Additional Information / Comments
Agreement
I am the parent or legal guardian of the above named child, and by registering I give permission for my child to attend Vacation Bible School at Believers' Bible Chapel and participate in all VBS activities. I authorize all medical, surgical, diagnostic, and hospital care or procedures which may be performed or prescribed for the above named child by a licensed physician or hospital, when efforts to contact me are unsuccessful and when deemed immediately necessary or advisable by the physician to safeguard my child’s health. I acknowledge that Believers' Bible Chapel will not be responsible for medical expenses incurred.
Should be Empty:

2026 VBS Registration Form

Parent/Guardian Information

Agreement