VBS Children's Registration

Vacation Bible School July 23 - 25, 2026
How many children are you registering?
Child Information
First Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies) N/A if not applicable.
Second Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies). N/A if not applicable.
Third Child
Child's Name

First NameLast Name
Child's Birth Date

MonthDayYear
Last Grade Completed
Medical or other information we may need to know about the child (including food allergies) N/A if not applicable.
Child Release Information
Parent/Legal Guardian Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState

Zip Code
Names of Person(s) to which the child (children) may be released to at the end of VBS each day

First NameLast Name
First NameLast Name
Emergency Contact 1 (other than parent/guardian listed above)

First NameLast Name
Emergency Contact 1 Phone Number

Area CodePhone Number
Media Release
By clicking the box below, I hereby Give Permission for photographs and/or video in which my child appears in to be used by the church in printed and/or electronic media, including the church's website.
Should be Empty:

Vacation Bible School July 23 - 25, 2026