Vacation Bible School Registration
Join us for a Snowball Mountain Challenge. Children ages 3 - Middle School are welcome to come!
Child's Name
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
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11
12
13
14
15
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17
18
19
20
21
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24
25
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29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
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1975
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1971
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1967
1966
1965
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1963
1962
1961
1960
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1952
1951
1950
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1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Home Phone Number
Format: (000) 000-0000.
Mobile Number
Format: (000) 000-0000.
Email Address
example@example.com
Desired Name Tag
Primary Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please provide any medical or dietary restrictions you have
How did you hear about VBS?
Please Select
Church Member
Facebook
Print Ads
Church Sign
Referral
Friend
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Last Grade Completed:
Do we have permission to photograph your child:
Yes
No
Family Information
Parent/Guardian's Name
First Name
Last Name
Contact Phone Number
Format: (000) 000-0000.
E-mail Address
example@example.com
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Emergency Contact Information
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Format: (000) 000-0000.
Relationship to Student
Submit Form
Should be Empty: