VBS 2026 Illumination Station Sign Up

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This form is for child and adult signups. Submit one form per child or adult attending.

Email *

Name of Child or Adult Being Registered: *

Birth Date *

YYYY

Current Address *

Grade *

Gender *

Male

Female

Parents Name *

Enter the Child's Parent's First & Last Name (only if signing up a child)

Emergency Contact Name *

Emergency Contact Number *

Medical Notes

If your child has any medical issues or allergies we should be aware of, please list them here.

Who is Authorized to Pick Up Your Child After VBS? *

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

Submit

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