VBS Registration

Register now for VBS 2015!

Please fill out an on-line form for each child to reduce registration time on the opening night. Nightly registration is available before the meeting to ensure no one is turned away. Only one form is required per child for the entire VBS, either on-line or on the first night attending.

Online Registration Form

a)  Fill out the online web registration form below
b)  Click Send to submit
c)  All fields must be filled out to enable the form to be submitted
d)  The date must follow a specific format: eg.  2015-08-10

Child's First & Last Name (Required)

Upcoming Fall Grade (Required)

House/Apt # & Street (Required)

City, State & Zip Code (Required)

Phone Number & E-mail (6168771234 format) (Required)

Home Church (Required) (Type "None" if not regularly attending a church)

Food Allergies (List in detail) (Required) (Type "N/A" if Not Applicable)

Other Allergies or Medical Considerations (List in detail) (Required) (Type "N/A" if Not Applicable)

Parent/Guardian First & Last Name (Required)

Emergency Contact First & Last Name (Required)

Emergency Contact Phone Number (6168771234 format) (Required)

Pictures of your child(ren) might be taken throughout the week for posterity, posting on our website and future VBS promotion materials. Please indicate if you DO or if you DO NOT give permission for use of such pictures that contain your child(ren).
 I Give My Permission I DO NOT Give My Permission

Authorizing Signature First & Last Name (Must be 18 or older) (Required)

Date (2014-05-22 format) (Required)

Submit (All Fields Must Be Completed Before The Form Can Be Submitted)