Lakeland VBS Student Registration

Lakeland VBS Student Registration

Location: Ebenezer IPC, 5935 Strickland Ave, Lakeland, FL 33812
July 9–11, 2026 | 6:00 - 8:30 PM
Family Information
Parent / Guardian Full Name

First NameLast Name
Email Address
example@example.com
Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Home Church
Emergency Contact
Emergency Contact Name

First NameLast Name
Relationship
Emergency Phone
Please enter a valid phone number.Format: (000) 000-0000.
Student Information
Children Attending
Consent & Release
Should be Empty:

July 9–11, 2026 | 6:00 - 8:30 PM