Vacation Bible School Student Registration Form

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July 14 - 18, 2025 from 5:30 p.m. to 8:30 p.m.

Theme: "Wonder Junction"

Ages: Preschool age 2 thru Grade 6

VBS is open to everyone.

Email *

Student's Full Name *

Student's Birthday *

Month / Day / Year

Student's Gender *

Age *

School Grade Completed *

If in preschool, will your child attend Kindergarten next year?

Yes

Not Applicable

Clear selection

Parent/Guardian Name *

Address *

Number and Street, City, State, and Zip Code

Parent's Cell Phone or Work Phone *

Please list the name of your home church (if applicable) *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

Please state any allergies (dietary and/or other) *

Please state any medical conditions *

T-Shirt Size *

Child's Extra Small

Child's Small

Child's Medium

Child's Large

Child X-Large

Adult Small

Adult Medium

Adult Large

Adult XX Large

Adult XXX Large

I understand that my child's photograph may be taken as a part of this program and pictures may be used in print/brochure, website, and/or social media without compensation. For the safety of all participants, names and/or ages will never be published. *

How did you year about our VBS program? *

A copy of your responses will be emailed to the address you provided.

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This form was created inside of New Bethlehem Presbyterian Church.