Event Registration

Register for Vacation Bible School by filling out the information below:

Parent/Guardian contact info:

First Name

Last Name

Email Address

Cell Phone Number

Home Phone Number

Street Address

City

State

Zip Code

Emergency Contact Name and Number

Child Information

Name (child 1)

Date of Birth

Grade Completed

Age

Name (child 2)

Date of Birth

Grade Completed

Age

Name (child 3)

Date of Birth

Grade Completed

Age

Is there a friend your child would like to be with?

Special Needs/Allergies/Other Concerns

Thank you for signing your child(ren) up for "Victory VBS"! Please download and print a copy of the medical release form to be turned in before or on the first day of VBS!