VBS Registration

Our VBS is a family VBS. All ages are welcome. The entire family is invited to stay and share the experience together.

Name of all family members attending Age (or write "Adult")
City: State:
Zip: E-Mail:
Home Phone: Cell Phone:
Drop-offs are only allowed for children age 3 and above. If parents are not staying, please provide the following:
Parent/Guardian Name(s):
Emergency Contact Number:
Names of adults allowed to pick up your child(ren):

Do you attend church regularly?   YesNo

If yes, name of home church:

Please list all allergies and medical conditions:

Name Allergy/Medical Condition

Any Comments or Questions?