VBS 2026 Participant Registration

June 7th-10th, 6:00PM-8:30PM | Please fill out this form and click submit.

Child Information

Name

*

Gender

*

Birthdate

*

Age

*

Last Grade Completed

*

Please select one option.

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

Days Attending

*

Please select all that apply.

Sunday, June 7th Monday, June 8th Tuesday, June 9th Wednesday, June 10th

Does your child have any medical or allergy concerns?

*

Please select all that apply.

Yes No

Please list any medical or allergy concerns if applicable

Does your child require any special needs?

*

Please select one option.

Yes No

Special needs required if applicable

Parent/Guardian Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Is anyone, other than the parent/guardian, authorized to pick up your child?

*

Please select one option.

Yes No

Name(s) and Phone Number(s)

Emergency Contact

Contact 1 Name

*

Contact 1 Phone

*

Contact 2 Name

Contact 2 Phone

Additional Information

Do you currently attend a local church?

*

Please select one option.

Yes No

If so, where do you normally attend?

Photo Disclosure

By registering, you are giving us permission to photograph or video your child for promotional purposes. If your child's photo cannot be used, please contact us.

By clicking SUBMIT you agree:

- You are the Parent or Guardian on this form.

- You have the authority to release this information provided.

- To all terms and conditions indicated on this form.

Description

June 7th-10th, 6:00PM-8:30PM

Please fill out this form and click submit.

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