VACATION BIBLE SCHOOL REGISTRATION 2026

CHILD INFORMATION - PART 1 - Each child must have their own PAGE 1 of registration.

The family information on pages 2-3 should only be completed one time if you are registering more than one child. The office will transfer family information for the remaining siblings.
Port Community Church

118 Main Street, Port Republic, NJ 08241

Vacation Bible School Registration 2026

JULY 27-31 [Monday-Friday]

PREK3-GRADE 7 ▪️ 6:00PM-8:15PM
Child's First and Last Name*

First NameLast Name
BIRTH DATE
FORMAT 00/00/00
GRADE GOING INTO FALL OF 2026; however, if you as a parent would like to have them in their current grade level, that is fine. Parents know best!*

PRE-SCHOOL (must be 3 and potty-trained & comfortable in a group setting)KINDERGARTENGRADE 1GRADE 2GRADE 3GRADE 4GRADE 5GRADE 6GRADE 7
Does your child have any MEDICAL CONCERNS or ALLERGIES that we need to be aware? There will be a nurse and emergency personnel on site during VBS.*
Does your child have any special social, emotional, or learning concerns? What can you tell us to help us serve your child in the best possible way.*

FAMILY INFORMATION - PART 2

If you have multiple children registering for VBS, you only need to complete this section one time. GO RIGHT ON TO PAGE 3.
Please list the first and last names of children represented by the following family information.
Parent or Guardian Name 1

First NameLast Name
Phone Number - PARENT OR GUARDIAN 1
Format: (000) 000-0000.
Parent or Guardian Name 2

First NameLast Name
Phone Number - PARENT OR GUARDIAN 2
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Home Church if you have one.
All are welcome here!
Designated Pick Up Person #1

First NameLast Name
Designated Pick Up Person #2

First NameLast Name
Designated Pick Up Person #3

First NameLast Name

SIGNATURE PAGE - PART 3

As per our Safe Church Plan, please note that all volunteers are screened and trained in safety protocols to ensure a safe and secure place of worship.
Pictures and videos will be taken throughout the week by Port Community Church VBS for use in our Craft Projects, Activities, Church social media, VBS Program. I hereby give my permission for my child to be included in the pictures.*
Please Initial
Medical Release: I (We), the parent(s) or guardian(s) of the above listed child(ren) grant permission for our child(ren) to participate in Vacation Bible School at Port Community Church and to receive medical treatment if necessary. If I (we) or the listed child care provider or emergency contact cannot be reached, I (we) give our permission to the staff to secure the services of a licensed physician to provide necessary care, including anesthesia, for my child's well-being. *
Please Initial
I (we) also release and agree to hold harmless Port Community Church and all its participants from any liability and assume all risk of injury, damage or expenses as the result of participation in activities in Vacation Bible School.*
Please Initial
Official Signature*
Type Above Name and Date (00/00/00)*
BE SURE TO HIT 'SUBMIT'.
Should be Empty:

CHILD INFORMATION - PART 1 - Each child must have their own PAGE 1 of registration.