VBS Registration

Please use this form to register a child for the Beech Creek Wesleyan Church Vacation Bible School for Summer 2025.

"*" indicates required fields

Child Name*

First Last

Child Age*

Address*

Street Address Address Line 2 City State ZIP Code

Home Telephone Number*

Parent/Guardian Name

First Last

Parent/Guardian Email Address*

Enter Email Confirm Email

Emergency Contact Name

First Last

Emergency Contact Phone Number*

Known Food Allergies*

Additional Information

If there is any other important information such as medical conditions or special needs that should be known please let us know here.

Photographs may be compiled to create a VBS memory book or DVD.

Please grant or deny permission for photographs*

I grant permission for my child to be photographed during his/her VBS experience

I DO NOT grant permission for my child to be photographed during his/her VBS experience

Please let us know who will be picking up your child at the conclusion of VBS.

Name*

First Last

Name

First Last

User Verification