2024 VBS Registration

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VBS is every evening July 8-12 from 6:00pm - 8:10pm. There will be a program Sunday, July 14 at 10 am for all to attend. Please submit a separate form for each child that is attending.

Email Address *

Child's First Name *

Child's Last Name *

Child's Gender *

Male

Female

Childs Age *

Child's Date of Birth *

YYYY

Last School Grade Completed *

Name of Parents/Guardians *

Address *

Phone # *

Secondary Phone#

Home Church

Allergies, Food Allergies, or other medical conditions *

Yes

If yes, please give detailed explanation:

Emergency Contact Name and Relationship to Child *

Emergency Contact Phone # *

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