Stellar – Shine Jesus’ Light

Date: June  4-8

Time: 5:30-8:30 pm with dinner

Who: K2-5th grades completed

What: Rotating Stations – Bible storytelling, music, recreation, crafts, science

00days00hours00minutes00secondsuntil we blast off into Vacation Bible School!

Welcome to VBS Registration!

Parent/Guardian Information

Name - Parent/Guardian*

First

Last

Address-Parent/Guardian*

Street Address City Postal / Zip Code

Phone-Parent/Guardian

Area Code

 - 

Phone Number

Parent/Guardian Email*

Church Affiliation

Additional Contact Information

Please list someone we can contact if the above parent/guardian cannot be reached.

Name - Emergency Contatct*

First

Last

Phone-Emergency Contact*

Area Code

 - 

Phone Number

Supper Information

Do you want to sign up for nightly supper during VBS ($15/person/week)?*

No VBS Supper

Yes VBS Supper

6502-Please select how many people:*

1 person

2 people

3 people

4 people

5 people

6 people

VBS Music

6502-Do you wish to purchase a VBS Music CD or Streaming Card($4)?*

No VBS CD/Streaming Card

Yes - VBS CD

Yes - VBS Streaming Card

VBS Participants

Please indicate how many Vacation Bible School Participants you would like to register.

Choose:*

1

2

3

4

Child #1

Name 1*

First

Last

Grade/Age Completed 1*

K2

K3

K4

K5

1st

2nd

3rd

4th

5th

Date of Birth 1*

Gender 1*

Female

Male

Allergy/Medical Concerns 1:

Child #2

Name 2*

First

Last

Grade/Age Completed 2*

K2

K3

K4

K5

1st

2nd

3rd

4th

5th

Date of Birth 2*

Gender 2*

Female

Male

Allergy/Medical Concerns 2:

Child #3

Name 3*

First

Last

Grade/Age Completed 3*

K2

K3

K4

K5

1st

2nd

3rd

4th

5th

Date of Birth 3*

Gender 3*

Female

Male

Allergy/Medical Concerns 3:

Child #4

Name 4*

First

Last

Grade/Age Completed 4*

K2

K3

K4

K5

1st

2nd

3rd

4th

5th

Date of Birth 4*

Gender 4*

Female

Male

Allergy/Medical Concerns 4:

Total

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