Vacation Bible School Registration

Join us for an amazing week! (One form per family)

Crew Leader Name (Internal Use)

🧒 Child #1 Information

Child Full Name *

Nickname

Gender *

M F

Age *

Date of Birth *

Allergies or Medical Conditions

Any special circumstances/needs? *

Yes No

🧒 Child #2 Information

Child Full Name

Nickname

Gender

M F

Age

Date of Birth

Allergies or Medical Conditions

Any special circumstances/needs?

Yes No

🧒 Child #3 Information

Child Full Name

Nickname

Gender

M F

Age

Date of Birth

Allergies or Medical Conditions

Any special circumstances/needs?

Yes No

🏡 Family Contact Details

Guardian Name(s) *

Street Address *

City *

State *

Zip *

Cell Phone *

Email Address *

Home Church

🚨 Emergency & Consent

Emergency Contact Name *

Emergency Phone *

I give permission to call 911 in case of emergency *

Photo Permission? Yes No

🌟 Special Needs Survey

We believe every child has God-given strengths! Please help us support your child by providing more details below.

Child’s Name

Parent’s Name

Medical Diagnosis or Educational Label

Primary means of communication

Favorite activities and interests

Activities that cause frustration

Best way to respond if overwhelmed

My child’s strengths

What suggestions do you have for the best experience?

What should we share with other children to help them understand your child?

VBS Online Registration

Vacation Bible School Registration