Register Your Child

Mini-VBS is for children ages 3 through grade 5. Free childcare is available for children younger than 3 while adults attend Trivia Night at the Community Learning Center. Please use this sign-up to register ALL children participating in Mini-VBS and childcare. Youth in grade 6 and above may volunteer to help with Mini-VBS and should register on the volunteer registration page.

We found some errors when you submitted your information. Please see below and fill in the information needed.

Parent Personal Information

Parent First Name:

Parent Last Name:

Address 1:

Address 2:

City:

Country:

State:

Zip:

Email:

Re-Enter Email:

Home Phone Number: (xxx-xxx-xxxx)

Cell Phone Number: (xxx-xxx-xxxx)

Other Phone Number: (xxx-xxx-xxxx)

Emergency Contact

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Phone 1: (xxx-xxx-xxxx)

Emergency Phone 2: (xxx-xxx-xxxx)

Alternate Pickup First Name:

Alternate Pickup Last Name:

Alternate Pickup Phone: (xxx-xxx-xxxx)

Other Information

Home Church (If Applicable):

I plan to attend the Adult Trivia Night happening at the same time as Mini-VBS. (Yes or No):