Hilltop Church

VBS Registration

Please fill out a registration form for each child you are registering for VBS. VBS is for Children 4 years old through those entering 6th grade in the upcoming school year.

First Name

Last Name

Birthdate

VBS is for kids 4 years old through entering 6th grade. Your child must be 4 by August 1st to attend VBS.

Grade Entering Into

Do you have a home church?

Yes

No

If yes, what church do you attend?

Phone Number

Email

Food Allergies

Any other pertinent Medical Information (allergies, asthma, etc.)

Emergency Contact First Name

Emergency Last Name

Emergency Phone Number

Emergency Contact Address

Apartment, suite, etc.

City

State

Zip/Postal Code

I hereby grant permission for Hilltop Church to record sounds, images, or video of my child while attending What A Mess VBS 2026. I also give permission for Hilltop Church at its sole discretion to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Hilltop Church.

Yes

No

Signature