Road Trip Vacation Bible School 2025 Registration Form

Please fill out this form and click submit. Contact Emily Graff with questions on this registration!

Parent/Guardian Information

Your Name

Other Parent/Guardian Name

E-mail

This address will receive a confirmation email

Other Parent/Guardian E-Mail

Your Phone

Other Parent/Guardian Phone

Your Address

Emergency Contact

Emergency Contact Name

Phone

Relationship to Family

Child Information

Number of Children Registering

Please select one option.

1 2 3 4

Child #1

Child #1 Name

Child #1 Birthdate

Child #1 Grade Entering 2025

Any Health Concerns/Allergies/Medications?

Child #2

Child #2 Name

Child #2 Birthdate

Child #2 Grade Entering 2025

Any Health Concerns/Allergies/Medications?

Child #3

Child #3 Name

Child #3 Birthdate

Child #3 Grade Entering 2025

Any Health Concerns/Allergies/Medications?

Child #4

Child #4 Name

Child #4 Birthdate

Child #4 Grade Entering 2025

Any Allergies/Health Concerns/Medications?

PHOTO RELEASE: I hereby give permission for images of my child(ren), captured during Vacation Bible School through video and photos, to be used for promotional material and publications, in print or online.

Please select all that apply.

Yes No

Volunteer Information

We are looking for VBS Helpers (adults and youth going into 7th grade and up) to assist in the following areas...

CREW LEADER: Guide small groups of kids through activities and join in the fun!

STATION LEADER: Teach in gifted areas of music, drama, crafts, games, or snack.

SET-UP and DECORATIONS: Create decorations and put them up and put supplies out before VBS.

CLEAN-UP: Help pack up supplies and decorations.

Thank you for your interest in volunteering!

Helper(s) interested:

I (we) would like to volunteer in the following areas:

Please select all that apply.

Crew Leader Station Leader Set-Up Clean-Up

Registration Fee

Online VBS Payment

1 Child ($35) 2 Children ($50) 3 or More Children ($75) I am interested in scholarship information. ($0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit. Contact Emily Graff with questions on this registration!

Road Trip Vacation Bible School 2025 Registration Form

Description

Please Fix the Following