Lititz Moravian VBS: June 22nd-26th
Please fill out the form below to register your student for VBS at the Lititz Moravian Congregation.
Sunday, June 22nd - Thursday, June 26th PM (6:00 - 8:00 PM in the Christian Education Building)

All participants must have completed Pre-K or be at least 4 years old through completed 5th grade.
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Student's Name
Student's Date of Birth
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Student's Age
Grade of School Completed (2024-2025)
Parent/Guardian Name
Mailing Address
Email
Phone Number
Home Church
Neurodiverse Conditions (ADHD, Autism, Dyspraxia, and Dyslexia, etc) 

Please include any information that would help your student have a more enjoyable experience. 
Other Disabilities (Visual Impairment, Hearing Impairment, Limited Mobility, etc)

Please include any information that would help your student have a more enjoyable experience.
Allergies 
Dietary Restrictions
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First Emergency Contact Name and Number
Second Emergency Contact Name and Number
Photo Release- Lititz Moravian has my permission to use my child's photograph publicly in VBS materials. I understand images may be used in print publications, online publications, presentations, websites, and social media. 
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