VBS 2026 Regristration Form (one per child) Send Button will email the form to church office.

Childs Name:

Patent/Guardian Name:

Field label

Street

City

State

Zip Code

Mailing Address (if different)

Field label

Home:

Work

Cell

Birth Date:

Last grade completed in school:

Medical Information: Any Medical of other information we need to know, including any food allergies.

Emergency Contacts: (other than those list above)

Dismissal Information: Who may pick up your child at the end of each VBS day?

Other Information: Does your child attend Church? if so, where?

May we have permission to photograph your child?

Yes 1

No 2

May we have permission to put a photograph of your child on our web site?

Yes 1

No2

Your Email: