2018 VBS Registration

June 10th - June 14th 6:30 p.m. - 8:15 p.m.
Participant's First Name: *
Participant's Last Name*
(Siblings must be entered separately).
Participant's Age:*
(For children aged 4 through completed 6th grade. All participants must be potty trained.)
Participant's Gender:
Grade Leaving:
    Not Started School Yet
 Finished Pre-K
 Finished   Kindergarten
 Finished  1st
 Finished  2nd
 Finished  3rd
 Finished  4th
 Finished  5th
 Finished  6th
Any known allergies?
Any medical conditions we should be aware of?
Parent's Name:*
Parent's Email Address: (Will only be used to email a confirmation, and for VBS-related emails).
Zip Code
Phone Number 1
Phone Number 2
Emergency Contact Name:*
Emergency Contact Phone:
Emergency Contact Relationship*
Home Church Name
Who would your child like to request a student to be with?

Friend request will only be accepted with registrations made by June 8th if both friends pre-register and attend VBS by Monday.

All requests honored only is possible and limited to one request per child.
If you would like to volunteer during VBS, please leave us a message here. We will contact you. Please note that child clearances are required to work with the children.
Any additional comments?