VBS 2026

1

Child's Name

First Name

Last Name

2

Parent/Guardian Name

First Name

Last Name

3

Cell Phone NumberPlease leave a number where you can be contacted during VBS.

Please enter a valid phone number.

4

Emergency ContactPlease give a name of some different than the parent/guardian listed above.

First Name

Last Name

5

Emergency Contact Phone NumberPlease give a number for the emergency contact.

Please enter a valid phone number.

6

Who can pick your child up?Please list all adults who will pick up your child from VBS.

7

Where do you attend church?

9

Any Allergies?Please list any allergies.

10

SignatureMay we photograph your child and use on social media?