Kimmels Church VBS 2018 Registration Form

Kimmels Church

VBS 2026 Registration Form

VBS Week: July 20-24 - 6 pm to 8:30 pm

For kids PK to those entering 6th grade

From the lush meadows of its countryside to the cobblestone streets of its cities, there is something to delight the senses everywhere we turn in Ireland. So mark your calendars now and have your kids journey with us during the week of July 20th as we head to the Emerald Crossing. Every stop along our path will teach us about the Good Shepherd and how he cares for his sheep.

Our kids will also enjoy a wonderful week of music, lessons, games, crafts and more!

FREE T-Shirt guaranteed to first 140 kids who are pre-registered!
(shirts will be available when you check in at VBS)
Birthday:
Please indicate grade your child will enter in the fall:
Child's Name

First NameLast Name
Gender:
What Is Your Child's T-Shirt Size?
Parent / Guardian:

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact if different from Parent or Guardian:

First NameLast Name
Emergency Contact phone number if different from Parent or Guardian:

Area CodePhone Number
Please list any food allergies:
Please list any medical concerns or anything you want us to know:
By registering your child you are giving us permission to photograph your child unless otherwise stated below
Thank You! We look forward to seeing you and your family during VBS Week!

Kimmels Church
179 Pine Creek Drive
Orwigsburg, PA 17961
570.943.2759
Should be Empty: