Register for VBS

Please Register for Vacation Bible School!

* Indicates required field

Parent/Guardian Name *

Phone Number *

Child 1 Name *

First

Last

Age *

Child 2 Name *

First

Last

Age *

Child 3 Name *

First

Last

Age *

Child 4 Name *

First

Last

Age *

Child 5 Name *

First

Last

Age *

Who is authorized to pick up your child(ren)? Please note, only listed individuals will be able to pick up your child(ren). *

Does your child(ren) have any food allergies? *

Yes No

If Yes, Please Explain: *

Does Your Child Have any Medical Conditions? *

Yes No

If Yes, Please Explain: *

Submit