VBS Registration

Vacation Bible School 2024 Registration Form
Monday June 3rd through Thursday June 6th
5:30 to 8:00 PM (Dinner provided)

* Indicates required field

Child's Name *

First

Last

Child's Birthdate (mm/dd/yyyy) *

Parent or Guardian Name *

First

Last

Parent/Guardian Email *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Phone Number *

Home Phone Number *

Work Phone Number *

Preferred phone *

Cell Home Work

Contact other than Parent *

Contact's Phone Number *

Contact's relationship to child *

School child will be attending 2024-2025 *

Child's grade in 2024-2025 school year *

Home Church or place of worship (if one) *

Allergies & Medications *

Submit