The Great Jungle Journey- VBS

June 24th-June 28th | Register your child(ren) for VBS. Spots are limited due to space and volunteers. Please check your email for important information leading up to and the week of VBS.

Parent/Guardian Full Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

I give the church permission to publish the likeness of my child(ren) to print, electronic, website, or video format

*

Please select all that apply.

Yes No I would like more information about why

Child Registration

Child's Full Name

*

Grade (Child will enter in the fall)

*

Please select all that apply.

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

Allergies

2nd Child's Full Name

Grade (Child will enter in the fall)

Please select all that apply.

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

Allergies

3rd Child's Full Name

Grade (Child will enter in the fall)

Please select all that apply.

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

Payment

1 child ($5.00) 2 children ($10) 3 children ($15) Requesting Scholarship ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

June 24th-June 28th

Register your child(ren) for VBS. Spots are limited due to space and volunteers. Please check your email for important information leading up to and the week of VBS.

Please Fix the Following

Close