VBS 2021 Registration Form
Thanks for choosing to register for VBS 2021! We're excited to be able to resume VBS this year! We look forward to having a great week learning about how Jesus' power can pull us through anything as we ride the rails of the Rocky Railway!
Rocky Railway VBS will be held in La Harpe from July 26-30th, 2021 from 9am-noon each day. It is a joint effort of the La Harpe Christian Church and Union Church. Each day will begin and end at the La Harpe Christian Church. Children will be served lunch each day before they leave. VBS is open to children in Pre-K through 8th Grade.
Child Information
Child First Name *
First name of child attending VBS
Child Last Name *
Last name of child attending VBS
Child Address *
The home address of the child attending VBS
City *
City in which child resides
State *
State in which child resides
ZIP Code *
ZIP Code in which child resides
Home Church
The church the child regularly attends (if none, write none)
Grade Entering in Fall *
Select the grade the child will be in this fall (if not beginning school yet, mark Pre-K)
Parent/Guardian Information
Parent/Guardian First Name *
First name of the parent or guardian of the child
Parent/Guardian Last Name *
Last name of the parent or guardian of the child
Parent/Guardian E-mail
E-mail address at which you can be reached
Parent/Guardian Phone Number
The phone number at which you can be reached
Emergency/Health Information
Emergency Contact *
Person we can contact in the event of an emergency during the week of VBS (during the hours of 9am-noon)
Emergency Contact's Relation *
The relationship of the emergency contact to the child (parent, grandparent, friend, etc.)
Emergency Contact Phone # *
Number at which we can reach the emergency contact during VBS
Allergies/Special Needs
Please list any allergies or special needs for which we may need to account
Additional Information
Friend/Sibling Group Request
Children will be divided up into crews with mixed age groups. If your child has a friend or sibling they'd like to have in their crew, let us know their name and we will try our best to make that happen!
Walk/Ride Permission
My Child has permission to walk/ride their bike home from VBS
Other Information
Any other information you think might be helpful for us to have
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