VBS 2025

Child's Name

*

Gender

*

Male Female

Birthday

*

Grade Completed

*

Address

*

Parent/Guardian

*

Phone

*

Email

*

This address will receive a confirmation email

Emergency Contact

*

Emergency Contact's Phone Number

*

Relationship to Child

*

Who can pick up your child

*

Name of home church

*

Food Allergies

*

Yes No

List of Allergies

Medical Concerns

*

Yes No

Explain

Description

June 16 - 20th

Please fill out this form and click submit to register for VBS 2025.