Vacation Bible Camp Registration

Register your child for this summer’s Vacation Bible Camp. Provide ages, dates, medical and emergency information. Scholarships may be available; see details on the form.

Complete the Registration Form

Please submit one form per child, including contact details, age/grade, allergies, emergency contacts, and permissions. After you submit, we will email confirmation and next steps.

Name

Camper First Name Camper Last Name

Camper Age

Name

Camper First Name Camper Last Name

Camper Age

Name

Camper First Name Camper Last Name

Camper Age

Name

Parent/Guardian 1 First Name Parent/Guardian 1 Last Name

Name

Parent/Guardian 2 First Name Parent/Guardian 2 Last Name

Preferred Email Address(Required)

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

In case of emergency, contact:

Emergency Contact Phone

Please list any allergies or other special needs