VBS Registration
December 27th-30th  from 9:00 to noon for ages 3yr- 6th grade
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Email *
Name of Child 1 attending VBS *
Grade for the 2022/23 school year *
T-shirt size *
Name of Child 2 attending VBS
Grade for the 2022/23 school year
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T-shirt size
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Name of Child 3 attending VBS
Grade for the 2022/23 school year
Clear selection
T-shirt size
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Name of Child 4 attending VBS
Grade for the 2022/23 school year
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T-shirt size
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Parent/Guardian First Name *
Parent/Guardian Last Name  *
Address *
City *
Zip Code *
Phone Number *
Emergency Contact/Phone *
Name of Person(s) authorized to pick-up from VBS *
How did you hear about Immanuel's VBS *
I consent to allow photos taken during VBS to be used in/on craft projects and church bulletin boards *
I consent to allow photos taken during VBS to be posted to the church website/Social Media accounts *
I understand that I will be notified in the case of medical emergency involving my child. In the event that neither I nor the above listed emergency contact can not be reached I authorize ILC to arrange for a doctor and providing of necessary medical servies as are deemed necessary to protect the welfare of my child. *
Required
Special need/allergies *
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