VBS 2025 - Registration Form

VBS 2025 - Registration Form
Parent / Guardian Name(s)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Numbers: Primary
Secondary Phone
Please enter a valid phone number.
Home Church (if any)
Children's Information

VBS is for 3 year olds (potty-trained) through students who completed 5th Grade
1st Child's Name
Age
School Grade (completed)
Allergies / Medical Info / Special Needs
2nd Child's Name
Age
School Grade (completed)
Allergies / Medical Info / Special Needs
3rd Child's Name
Age
School Grade (completed)
Allergies / Medical Info / Special Needs
4th Child's Name
Age
School Grade (completed)
Allergies / Medical Info / Special Needs
Emergency Contacts
Contact #1
Phone
Contact #2
Phone
Dismissal Information
Individuals who may pick up child(ren) from VBS
Photo Consent & Release
May we have permission to photograph your child:

YESNO
May we have permission to use your child's photograph for the purpose of promotion?

YESNO
Registered Friends
Does your child have a friend attending?

YESNO
Friend's Name
Age
How did you hear about us?
Please register by July 21, 2025.
Should be Empty:

Emergency Contacts