2024 VBS Registration

June 24-28 from 9:00am to Noon | We would love for you to join us for our VBS Family Night on Friday, June 28 from 5:30 to 7:30 pm.

Child's Name (First/Last)

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Primary Parent/Guardian Name (First/Last)

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Address

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Phone

*

Email

*

This address will receive a confirmation email

Grade Entering

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Please select one option.

Pre-School Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Date Of Birth (MM/DD/YY)

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Is This Child Fully Potty Trained? (This Is Required To Attend VBS)

*

Please select one option.

Yes No

Does This Child Have Any Allergies?

*

Please select one option.

Yes No

Does This Child Have Any Medical/Health Concerns That Would Not Be Considered An Allergy?

*

Please select one option.

Yes No

Please Explain Any Medical Concerns Or Allergies

Does this child have any behavior or learning needs that would be helpful for our leaders to know about?

*

Please select one option.

Yes No

Please explain any behavior or learning needs

First Emergency Contact (Name/Phone Number)

*

Second Emergency Contact (Name/Phone Number)

*

List Any Additional Authorized Persons For Pickup

*

Do You Agree To Contact The Church If You Would Not Like Photos Of Your Child To Be Taken At VBS?

*

Please select one option.

Yes No

Are You Interested In Joining Us For Our Family Night From 5:30-7:30 pm on June 28th?

*

Please select one option.

Yes No

If You Are Visiting Our Church, How Did You Hear About VBS?

Do You Regularly Attend A Different Church In The Area?

Please select one option.

Yes No

If So, Which Church Do You Attend?

Description

June 24-28 from 9:00am to Noon

We would love for you to join us for our VBS Family Night on Friday, June 28 from 5:30 to 7:30 pm.

Please Fix the Following

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