2024 VBS Registration Form

Camper Name

Parent/Guardian Name

Email Address

Home Telephone

Cell phone

Date of Birth

Age

Last Grade Completed

Home Church (if any)

Friends of your child at this church

Allergies/Medical conditions (if any)

Emergency Contact

Name of person picking up child

Photo Release. Church has my permission to use my child's photography publicly in VBS materials, media, online video or social media. I understand that no royalty fee or compensation shall become payable to me for such use.
Select OptionYesNo

Parent Guardian Signature

Download the waiver, sign it and bring it on the first day of VBS.

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