VBS Registration Form-Child 2026

About Your Child

Name:

Gender:

Male Female

Date of Birth:

Entering Grade

1st 2nd 3rd 4th 5th 6th

List any medical conditions, issues, allergies, or medications your child has:

Home Church

Parent/Guardian Contact Info

First Name:

Last Name:

Mailing Address:

Email:

This address will receive a confirmation email

Phone:

Emergency Contact Info

(Someone other than yourself)

First Name:

Last Name:

Relationship to Your Child:

Phone:

Unnamed Label

Description

June 22 to June 26

Join us at our Illumination Station Vacation Bible School on June 22-26, 9 am-noon, M-F!