Child's Name First Last NicknameDate of Birth:(Required) MM slash DD slash YYYY Upcoming school grade (fall 2025)Pre-KKindergartenThird Choice12345678Siblings attending VBS:Does your child have one or more friends / peers attending VBS? If so, list them here:Home congregation (if any):Please list any allergies (including food allergies) that VBS staff should be aware of:Parent/Guardian 1Parent 1 Name(Required) First Last Parent 1 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent 1 Cell Phone(Required)Parent 1 Email Address(Required) Parent/Guardian 2Parent 2 Name(Required) First Last Parent 2 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent 2 Cell Phone(Required)Parent 2 Email Address(Required) Emergency ContactIn case of emergency, we need a contact person on file if the parent/ guardian cannot be reached:Emergency Contact Name(Required) First Last Emergency Phone number(s):(Required)Relationship to Participant:(Required)Person/people who will pick up participant at the end of the VBS day:NamePhone number(s)Relationship to Participant Add RemoveWe love it when caregivers volunteer! Please indicate below if you would like to help:(Required) I can volunteer during all 5 days of VBS (bonus: we waive one registration fee for your child!) I can volunteer on the following days I can volunteer to help with set up & decorating the week before VBS I can volunteer to help with cleanup & breakdown on the last day of VBS I am unable to volunteer I can volunteer on the following days Monday Tuesday Wednesday Thursday Friday Throughout VBS, we may take videos or photos of the kids in action, to share the joy of VBS with future possible campers! We only share photos and videos of kids who have a signed Media Release Form. A Media Release Form will be emailed to you the week before VBS. We are so excited to have your child at VBS! Is there anything you would like us to know so we can make sure they have the best week possible?:Parent / Guardian NameDate(Required) MM slash DD slash YYYY
