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VBS Registration

Please fill out the form below as completely and accurately as possible. Then click the submit registration button to send in the registration for your child. Please make 1 submission per child.

Child's Name:  Age:  DOB: 
Boy Girl   Last Grade Completed:   Parent(s) Name:
Street Address: City: State: Zip:
Home Phone:   *Cell Phone:   *Home Church:
In case of emergency contact:   at:
*Food Allergies:   *Medical Conditions:
*Want to experience VBS with your child? Want to volunteer in other ways? Check days you can help out:
SundayMondayTuesday WednesdayThursday
*Name of child or leader your child might like to be with (no guarantees):
I approve of my child being photographed (which may be used in "in-house" videos/promos)
I do not approve of my child being photographed (and will not be used in "in-house" videos/promos)

* Field is optional. All other fields are required.