2018 VBS Registration

VBS 2018 -- Splash! -- June 18-22

Questions? Contact our VBS Director, Joni Gerdes (712)-359-7706 for additional information.

* Indicates required field

Name *

First

Last

Age *

Grade (entering this fall) *

Parents / Guardian *

Address *

Home / Cell Phone *

Email *

Need help with transportation? *

Yes No

Emergency Contact *

Emergency Contact Phone *

Allergies *

Other Medical Concerns *

May we publish picture(s) of your child on our church website and/or Facebook page? *

Yes No

Submit