ILLUMINATION STATION - 2026 VBS Registration

General Information

Parent/Guardian Name

This address will receive a confirmation email

Phone Number

Address

If you do not attend Chapel Pres regularly, how did you learn about this year's VBS?

If you do not attend Chapel Pres regularly, do you have a home church? If yes, will you share the name of your church?

Would you like more information about Chapel Pres? Yes, please! No thanks!

Participant Info - Age 4 by Jan 1, 2026 thru 5th Grade Completed

Child #1 First Name

Child #1 Last Name

Child #1 Age

Child #1 Grade (completed)

Child #1 Allergies or Relevant Medical Information

Child #2 First Name

Child #2 Last Name

Child #2 Age

Child #2 Grade (completed)

Child #2 Allergies or Relevant Medical Information

Child #3 First Name

Child #3 Last Name

Child #3 Age

Child #3 Grade (completed)

Child #3 Allergies or Relevant Medical Information

Child #4 First Name

Child #4 Last Name

Child #4 Age

Child #4 Grade (completed)

Child #4 Allergies or Relevant Medical Information

Emergency/Alternate Pick-up Information

Emergency Contact Name

Emergency Contact relationship

Emergency Contact Phone

Is anyone else permitted to pick up your child(ren)?

Yes, see info below No

Please list names and contact info for anyone else who is permitted to pick up your child(ren):

Description

Monday-Friday, June 15-19, 9:00-11:45 am

For ages 4 (by Jan 1, 2026) through 5th grade completed

Jesus spoke to them again: “I am the light of the world. Anyone who follows me will never walk in the darkness but will have the light of life.” John 8:12

Any questions or concerns can be directed to erinkickasola@gmail.com

ILLUMINATION STATION - 2026 VBS Registration

Description

Please Fix the Following