VBS 2022
If you or your child would like to participate in this event as a Participant, please complete the following form.

(If you are under 18, please have your parent or guardian complete the form.)

If you have previously registered with us for a prior event, you can search for your stored information instead of filling out the form below.
Personal Information
Welcome we are so excited that you are going to join us for the BEST WEEK OF THE SUMMER! Remember: VBS is for those kids who have COMPLETED Kindergarten thru 5th grade.
*Participant's First Name:
*Participant's Last Name:
*Parent/Guardian Name:
*Email:
*Address:
*City:
*State:
*Zip:
Home Phone:
(555-555-5555)
Work Phone:
(555-555-5555)
*Cell Phone:
(555-555-5555)
*Birthday:
(MM/DD/YYYY)
*Last Grade Completed:
*Gender:
Allergies, Medical, & Special Needs:
(Leave Blank if None)
*Emergency Contact Name (1):
*Emergency Contact Phone (1):
(555-555-5555)
*Authorized Pickup #1:
*Authorized Pickup #2:
Are you a member of this church?
Guest of:
Do you attend Church?
If so, where?
May we have permission to use your child's photograph in church publications?
Comments:
*Preferred Name for Name Tag:
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