Shipwrecked VBS Registration
Vacation Bible School hosted by Northmont Church!

For kids, age 3 through 6th grade. All participants must be fully potty-trained and have completed one year of preschool or grade school.

June 24-28, 2019

If you would like to register your child(ren) for VBS, please fill in your details in the form below and you will be automatically registered.

Early Registration until June 7th - $15.00 per child
Regular Registration after June 7th - $20 per child
(Each family unit will max out at $40 no matter how many children they register)

*Don't let money be an issue! Scholarships are available. Contact Steph Martin at for more information*

Please make checks payable to Northmont Church with "VBS" in the memo line. You can mail your check to the church office.

Northmont United Presbyterian Church
8169 Perry Highway
Pittsburgh, PA 15237

Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Email *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Guardian Cell Phone *
Your answer
Additional Parent/Guardian Name *
Your answer
Additional Parent/Guardian Number *
Your answer
Relationship to Child *
Your answer
Child's Home Church *
Your answer
How did you hear about our VBS? *
Your answer
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