Shipwrecked VBS is August 4th, 5th, 6th and 7th from 6:30 to 8:30. It is going to be a blast! We are so excited that your kids are going to join us! This form will ask for your email so a copy of your response will be sent back to you. Please fill out one form for each child you are registering, and hit submit at the bottom after completing all of the fields for each form. You can fill out as many forms as you need.
Child's Last Name
Child's First Name
Allergies or special needs that staff and volunteer should be aware of?
Parent/Guardian Last Name
Parent/Guardian First Name
Parents/Guardians will sign a permission form the first night their child attends VBS.
Additional comments or concerns?
All done! Hit the submit button at the bottom and if you would like to register another child return to this form afterward.
You can email Lighthouse at
or call at (570) 420-8196
A copy of your responses will be emailed to the address you provided.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service