Vacation Bible School | Mount Pleasant Baptist Church

Vacation Bible School Registration Form

July 12-15, 2026
One form per family – use additional forms for relatives or friends
Ages 4 through entering 6th grade in the fall are welcome!

VBS Registratation

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This field is for validation purposes and should be left unchanged.

Parent/Guardian Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Email(Required)

Cell Phone

Home Phone

Work Phone

Emergency Contact #1 Name & Relationship(Required)

Emergency Contact #1 Phone Number(Required)

Emergency Contact #2 Name & Relationship

Emergency Contact #2 Phone Number

Who make pick up your child at the end of each day? *Only those listed here will be allowed to leave with your child.(Required)

How many children are you registering?(Required)

Child #1

Child #1 - Name(Required)

Child #1 - Grade Entering in the Fall(Required)

Child #1 - Age(Required)

Child #1 - Shirt Size(Required)

Please Indicate Youth or Adult

Child #1 - Medical/Allergy Information(Required)

Child #2

Child #2 - Name(Required)

Child #2 - Grade Entering into Fall(Required)

Child #2 - Age(Required)

Child #2 - Shirt Size(Required)

Please Indicate Youth or Adult

Child #2 - Medical/Allergy Information(Required)

Child #3

Child #3 - Name(Required)

Child #3 - Grade Entering into Fall(Required)

Child #3 - Shirt Size(Required)

Please Indicate Youth or Adult

Child #3 - Age(Required)

Child #3 - Medical/Allergy Information(Required)

Child #4

Child #4 - Name(Required)

Child #4 - Grade entering into in Fall(Required)

Child #4 - Age(Required)

Child #4 - Shirt Size(Required)

Please Indicate Youth or Adult

Child #4 - Medical/Allergy Information(Required)

Child #5

Child #5 - Name(Required)

Child #5 - Grade entering into Fall(Required)

Child #5 - Age(Required)

Child #5 - Medical/Allergy Information(Required)

Agreements

To assist in easy registration, please submit the form by July 9, 2026.