VBS '26 Participant Registration

July 27-30, 9 AM-12 PM | Please fill out this form and click submit.

Participant's Name

*

Preferred Name for Name Tag

Parent/Guardian Name

*

Address

*

Primary Phone

*

Email

*

This address will receive a confirmation email

Birthday

*

Age/Grade(going into)

*

Please select one option.

PreK Kinder 1st Grade 2nd Grade 3rd Grade 4th Grade 5th grade 6th Grade

Allergies, Medical, & Special Needs:

Emergency Contact Name (1)

*

Emergency Contact Phone (1)

*

Emergency Contact (2)

Emergency Contact Phone (2)

Authorized Pickup #1

*

Authorized Pickup #2

Authorized Pickup #3

Authorized Pickup #4

Are you a member of this church?

*

Please select one option.

Yes No

Guest of:

Do you attend church?

*

Please select one option.

Yes No

If so, where?

May we have permission to photograph your child?

*

Please select one option.

Yes No

May we have permission to use your child's photograph in church publications?

*

Please select one option.

Yes No

Comments:

T-shirt

Please select one option.

Youth Small Youth Medium Youth Large Youth XL Adult Small

Description

July 27-30, 9 AM-12 PM

Please fill out this form and click submit.

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