VBS registration
Event Timing: Sunday August 5th to Thursday August 9th, 6:30pm-8:30pm
Event Address: 1849 S Forge Rd, Palmyra, PA 17078
Contact us at 717.838.1129 or music@cbcpalmyra.org
For children ages 3 through 5th grade
Email address *
Time Lab Theme
Child's First Name *
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Child's Last Name *
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Child's Age *
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Parent/Guardian's Name *
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Contact Phone Number *
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Additional Emergency Contact Phone Number *
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Food Allergies & Special Requests
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Current attending church (if applicable)
Any other comments or information
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