VBS Registration 2026
Please fill out this form and click submit.
Student's name
*
Parent/Family/Guardian Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Email
*
This address will receive a confirmation email
Phone (Home/Mobile/Work)
*
Date of Birth
*
Age
*
Last school grade completed
*
Home Church (if any)
*
Emergency Contacts (Name & Phone number)
*
Emergency Contacts (Name & Phone number)
*
Name(s) of person who may pick this child up from VBS
*
Please list any allergies/health concerns
*
Photo Release:
Brick Presbyterian Church/VBS has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use. Parent/guardian's signature:
*
Submit
Description
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