VBS Registration Form

2025 Mountain of Miracles VBS July 14-18 9:00am – 12:30pm

Waitlist Form (One per Child)

Child's First Name *

Child's Last Name *

Child's Nickname

Child's Gender

Child's Age *

Child's Grade *

Date of Birth *

Allergies or Other Medical Conditions (i.e. diabetes) *

Snack Options:

Vegetarian

Plant-based

Any special circumstances we should be aware of? (special needs or disabilities, and/or specific considerations).

Yes

If yes, please explain below.

First Name of Guardian/Parent *

Last Name of Guardian/Parent *

Street Address *

City *

Province *

Postal Code *

Home Phone

Cell Phone *

Email *

Home Church

Custodial Arrangement (if applicable)

In Case of Emergency, Contact *

Phone *

Relationship to Child *

Photographs and video will be taken during VBS. Do you give permission for your child’s photo to be taken?

Yes

Date *

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