VBS Registration

Please register one child at a time. Thank you!

Vacation Bible School
June 24-28 | 10am-12pm

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    Child’s Name (First and Last)*

    Child’s Birthdate*

    Parent or Guardian’s Name (First and Last)*

    Street Address*

    City*

    Zip Code*

    State*

    Phone Number where you can be reached during VBS*

    Parent or Guardians Email*

    Grade Entering This Fall*

    K1234567

    Known Allergies or Medical Conditions

    Medications Needed While at VBS

    Name of siblings attending VBS this year

    I will be attending the Friday Lunch & Closing Program*

    YesNoMaybe

    Transportation Is Available*

    Transportation NeededTransportation Not Needed