Indian Creek Baptist Church VBS 2026

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Event Timing: June 15th - June 19th, 2026
Event Address: 311 Baptist Church Rd, Mill Run, PA 15464
Contact us at icbcmillrunpa@gmail.com

*You will need to fill out this form for each child that plans on attending VBS this year!*

Email *

Name of Child Attending: Please put the child's FIRST and LAST name in this box, thank you. *

Current Age of Child *

Parent or Guardian Name(s)

Phone Number of Parent or Guardian *

Home Address *

What grade did your child complete this past school year? *

Pre-School

Kindergarden

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Middle School, Grades 6-8

Highschool, Grades 9-12

Required

How will your child be picked-up from VBS during this week? *

Parent Pick-Up

ICBC Bus

Faith Learning Center Bus

Volunteer

Other:

Please list names of adults authorized to pick-up you child from VBS.

Example: John Doe, (Phone Number)

Does your child have any dietary restrictions? Allergies?

(If "None" Applies please leave this question Blank!)

Does your child have any medical conditions, we need to be aware of?

(If "None" Applies please leave this question Blank!)

Permissions *

I give permission for my child to attend ICBC's weekly meetings and special events and release ICBC and ICBC leaders from any liability incase of illness or injury that may result from these activities.

I give ICBC leaders permission to use pictures from ICBC events of my child on social media, ICBC's website, or in print.

I DO NOT allow ICBC leaders permission to use pictures from ICBC events of my child on social media, ICBC's website or in print.

Required

By digitally signing this Google Form you give permission for all checked boxes above and for those listed to check your child in and out of our program.

Please include First and Last Name.

Send me a copy of my responses.

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