VBS 2025 registration

Breaker Rock Beach VBS sponsored by several community churches. At LICF- July 28 - July 31, 2025 from 6pm until 8:15 pm. The 31st will be a wet and wild beach party with water activities, snacks, games and crafts.
Ages 4-12 (pre-k-6th grade)

* Indicates required field

Name of Child attending *

Birthdate *

Gender *

Male Female

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian Name *

First

Last

Email *

Home/Cell Phone *

Work Number *

In case of emergency *

First

Last

Relationship to Child *

Emergency Phone Number *

Who can pick up your child? *

Medical concerns *

Food allergies *

Comment *

Last school grade completed *

Name of home church *

Submit