Vacation Bible School Registration

Student Name

First

Last

Student Age or Class in 2026-27

Parent/Guardian Name

First

Last

Email

Cell Phone

Cell Phone Carrier

Emergency Contact Phone

Chronic or recurring illness or medical condition that may affect Bible School:

Dietary Restrictions we should know about:

If your child will be 1st-6th grade, do you give permission for your child to be transported in a school bus to Riverside Bible Camp in Story City on Thursday, June 18, 2026?

Yes, my child may go to Riverside for the day.
Probably, my child will likely go on the bus to Riverside but I’ll confirm by June 1.
Probably not, I don’t think my child will go to Riverside for the day but I’ll confirm by June 1.
No, my child will NOT go to Riverside on the bus.

Permission:

I give permission for my child to participate in all aspects of Bible School except as noted. I understand that every effort will be made to contact me if my child needs emergency treatment. I authorize medical personnel or VBS Staff to secure any medical treatment deemed necessary for my child. I give permission for pictures to be taken of my child to be used for promotional purposes (e.g. Facebook picture gallery.)

Preschool Children ages 3 – 5

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