VBS 2019 ~ 8:45am to 12:30pm
Please fill out the following to register your child/children for VBS 2019 ~ July 15-19, 2019. A separate registration is required for each child. Please read the Photo Waiver and the Liability Release statements. VBS is $25 per child and an online payment option is below.

PreK 4 & PreK5 classes are filled.

Child's first name *
Your answer
Child's last name *
Your answer
Parent's name *
Your answer
Street address *
Your answer
City, State *
Your answer
Zip *
Your answer
Parent cell phone *
Your answer
Email address *
Your answer
Grade completed in MAY 2019 *
Birthdate month *
Birthdate day *
Birthdate year *
T-shirt size *
Emergency contact name *
Your answer
Emergency contact phone number *
Your answer
Allergies/Conditions/Medications *
Note: If your child has food allergies, please supply a daily snack for your child.
Your answer
Friend Request
If you would like to request a friend for your child to be paired with, please list his/her name. We will do our best to accommodate your requests.
Your answer
Name of church or "No church home" *
Your answer
I have read and agree to the terms of the Liability Release and Photo Waiver Statement. *
Note: Please find a link to the statement on our website.
Required
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