VBS Registration 2025

June 22-26, 2025, 6:00-8:30pm

To register your child for VBS, please fill out this form and click submit.

Parent Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Do you attend church?

*

Please select one option.

Yes No

Name of church where you attend

*

How did you hear about VBS?

*

Please select one option.

Mailing Facebook From a friend Announcement at church Sign at church Other

Child First & Last Name

*

Child Date of Birth

*

Child Age

*

Please select one option.

4 5 6 7 8 9 10 11 12

Last Grade Completed (2024-2025 School Year)

*

Please select one option.

Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Has not attended school yet

Does your child have any allergies?

*

Please select one option.

Yes, my child has allergies No, my child does not have allergies

Please list any allergies. If none, please mark n/a.

*

May we have permission to photograph your child?

*

Please select one option.

Yes, you may photograph my child. No, you may not photograph my child

Name of person picking up your child?

*

Emergency Contact Information

Emergency Contact Phone Number

*

Description

June 22-26, 2025, 6:00-8:30pm

To register your child for VBS, please fill out this form and click submit.

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