Vacation Bible School

Cost is $70 for the first child, and $50/each for additional children.

Parent/Guardian Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Parent/Guardian Email REQUIRED Please fill out this field. Please enter an email address.
Parent/Guardian Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Mom's Cell (if different) Maximum 20 characters Please enter a phone number.
Dad's Cell (if different) Maximum 20 characters Please enter a phone number.
Emergency Contact Name (other than parent) REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

Would you like to purchase a music CD? REQUIRED 0.0 – No thanks 8.0 – Yes please Please fill out this field.

First Child

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Gender REQUIRED Boy Girl Please fill out this field.
Date of Birth REQUIRED Please fill out this field. Please enter a date.
T-Shirt Size REQUIRED Please fill out this field.
Grade in Fall 2026 REQUIRED Please fill out this field.
Allergies or Important Medical Information (if none, please type N/A) REQUIRED Please fill out this field. Please enter valid data.
We must have a Form A on file for each participant. You can fill that out at this link.
I acknowledge that the Form A waiver has been filled out for this child. REQUIRED Form A Waiver Please fill out this field.
Cost is $70 for the first child.70.0

Additional Siblings
Cost is $50 for each additional sibling. If you'd like to register more than 2 additional siblings, please contact Jenni Butch at [email protected].

Additional Siblings Please fill out this field.
Additional Sibling 1
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Gender Boy Girl
- Date of Birth Please enter valid data.
- T-shirt Size
- Grade in Fall 2026
- Allergies or Important Medical Information (if none, please type n/a) Please enter valid data.
- We must have a Form A on file for each participant. You can fill that out at this link.
- I acknowledge that the Form A waiver has been filled out for this child. Form A Waiver
- Additional siblings are $50/each50.0
Additional Sibling 2
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Gender Boy Girl
- Date of Birth Please enter valid data.
- T-shirt Size
- Grade in Fall 2026
- Allergies or Important Medical Information (if none, please type n/a) Please enter valid data.
- We must have a Form A on file for each participant. You can fill that out at this link.
- I acknowledge that the Form A waiver has been filled out for this child. Form A Waiver
- Additional siblings are $50/each50.0

I give permission for my child(ren) to have his/her picture taken. REQUIRED Yes No Please fill out this field.

Vacation Bible School

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