Vacation Bible School

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Register Your Child

Please fill out the form below and read and acknowledge the waiver.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

First Name

Last Name

Child's Birthdate

Child's Grade in School

Does you child have any allergies?

Any behavioral issues or delays?

Parent's First Name

Parent's Last Name

Parent's Phone

(Optional) Other Guardian's Phone

Address

City

Zip / Post Code

Emergency Contact *

Additional People Allowed for Pick Up (other than registering parent)

I understand and agree that Purpose Church may use the child's image/likeness in promotional materials for the church, and that all photos/videos are the property of Purpose Church.

I have read and agree to the waiver at the top of this page.