2026 VBS Participant's Registration

Please fill out this form and click submit.

📅Dates: July 20-23

🕕 Time: 6:30-8:30 p.m.

📍 Location: Childrey Baptist Church

👧👦 Ages: 3 - Grade 5

Child's Name (First, Last)

Child's Gender

Please select all that apply.

Male Female

Child's Date of Birth

Last School Grade Completed

Please select one option.

Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th Not in School yet but age 4

Check here if your child has any special needs or accommodations.

Please select all that apply.

Yes

If you clicked yes above please list specific needs of your child.

Group Preference - Please let us know if your child needs to be in a certain group. It is NOT guaranteed that your child will be in this group!

Parent/Guardian Information

Parent/Guardian Name

Email

Phone

Address

Home Church

VBS Group # (for church use only)

Please select one option.

P1 1 Middle School Youth High School Youth

Allergies or other medical conditions:

In case of an emergency, contact:

Emergency Phone Number:

Relationship to Child:

Please list 3 people authorized to pick up your child:

Child's T-Shirt Size

Please select one option.

Youth - Small Youth - Medium Youth - Large Adult - Small Adult - Medium Adult - Large Adult - XLarge Adult - XXLarge

Description

Please fill out this form and click submit.

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