Virtual Registration Form

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Welcome to Virtual Summerama VBS 2021, for children 4 years old to entering 6th grade! Please use a separate form for each child you register. Be sure to select the appropriate session based on your child's age and/or grade. Videos will post on Saturday, August 7 on Rutherford Bible Chapel's YouTube page. Videos can be viewed any time at your convenience. Supply kits can be picked up at a Drive-By Pick-Up in mid-July (date TBD).

Child's first name *

Child's last name *

Child's birthday: month/day/year *

Parent Email *

Street Address *

City, State and Zip Code *

Phone number *

Your child's grade level *

PreK

Child's T-shirt size *

Youth S

Youth M

Youth L

Youth XL

Adult S

Adult M

Adult L

Option 8

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