VBS 2022 Registration
Welcome to our VBS Online Registration! Please fill out this form completely.  VBS registration is not tied in to any other church system, and we need all of this information.  

Registration opens Monday, May 8. Please register online by Monday, June 5.
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Child's Name *
Parent/Guardian Name *
Street Address *
City *
State *
Zip Code *
Main Phone # (Home or Cell) *
Work Phone #
Mobile #
Email *
Child's Birthdate *
(m/d/yyyy) - Your child must be 4 years old by June 13, 2022 in order to attend VBS
Child's Last Grade Completed *
Emergency Contact 1 *
Name and Phone #
Emergency Contact 2
Name & Phone #
Who may pick up your child at the end of VBS each day? *
Do you attend Church? If so, where?
If you are visiting our church, are you coming with someone? If so, who?
Allergies/Medical needs we should know about? *
May we use photos and/or videos of your child for promotional purposes? *
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