VBS 2026 REGISTRATION

July 12-16, 2026 from 6:00-8:30 p.m. | Please complete this form to reserve your child's space in our 2026 VBS.

Child's Name

*

Gender

*

Please select one option.

Male Female

Birthdate

*

Grade Completed

*

Please select one option.

Pre-K 3 Pre-K 4 Kindergarten 1st 2nd 3rd 4th 5th 6th 7th

Address

*

Cell Phone

*

Parents/Guardian

*

Email

*

This address will receive a confirmation email

Emergency Contact

*

Relationship to Child

*

Phone

*

Who can pick up your child?

*

Name of home church

Food allergies?

*

Please select one option.

Yes No

List food allergies

Medical concerns

*

Please select one option.

Yes No

Explain any medical concerns

May we use your child's photo in promotional materials?

*

Please select one option.

Yes No

OPTIONAL: T-SHIRT ORDER

If you would like to order a VBS Illumination Station t-shirt for your child, please pay Ms. Kortney by June 25th. Shirts are $12 each. Please indicate the size needed below.

YOUTH SIZES:

Please select all that apply.

X-Small Small Medium Large

ADULT SIZES:

Please select all that apply.

Small Medium Large

Description

July 12-16, 2026 from 6:00-8:30 p.m.

Please complete this form to reserve your child's space in our 2026 VBS.

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