VBS 2026 Children's Registration

June 15-19, 2026 | Join us for Illumination Station Vacation Bible School at Immanuel!
MON - FRI / 5:30 to 8:15 p.m. / Immanuel Ministry Center, 1201 N China Lake Blvd.
Free for children entering Kindergarten through 6th grade!

Allergy Information-
Our snacks this year will contain:
Cheese, Eggs, Flour, Sugar, Milk, Whipped Cream, Butter, Watermelon, Strawberries, Blueberries, Grapes, and Food Coloring

JUNE 15th - 19th, 2026

5:30 - 8:15 p.m. at Immanuel Ministry Center / South Entrance

Incoming Kindergarten - Incoming 6th Grade

PLEASE COMPLETE ONE FORM FOR EACH CHILD

Child's Name

Birthdate

Grade they will enter in August 2026

Please select one option.

Incoming Kindergarten Incoming 1st Grade Incoming 2nd Grade Incoming 3rd Grade Incoming 4th Grade Incoming 5th Grade Incoming 6th Grade

Address

Does your child have an allergy, special need, learning disability, or behavioral diagnosis you'd like to share so we're prepared to help them feel as safe and comfortable as possible?

Please be advised that this year's theme contains lighting effects, including strobe lights, that may affect individuals with photosensitive epilepsy or other medical conditions. If you think your child may struggle with this, please describe here:

May we have permission to photograph your child?

Please select one option.

Yes No

Parent/Guardian's Name

Parent/Guardian's Phone Number

Parent/Guardian's Email

This address will receive a confirmation email

Emergency Contact's Name

Emergency Contact's Phone Number

Church Affliation:

VBS T-shirt Pre-Sale just $8 ($10 at the door)

T-Shirt Youth Sizes

Please select one option.

XS Small Medium Large XL

Payment Options

($0) ($8.00)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

June 15-19, 2026

Join us for Illumination Station Vacation Bible School at Immanuel!
MON - FRI / 5:30 to 8:15 p.m. / Immanuel Ministry Center, 1201 N China Lake Blvd.
Free for children entering Kindergarten through 6th grade!

Allergy Information-
Our snacks this year will contain:
Cheese, Eggs, Flour, Sugar, Milk, Whipped Cream, Butter, Watermelon, Strawberries, Blueberries, Grapes, and Food Coloring

VBS 2026 Children's Registration

Description

Please Fix the Following