2026 Vacation Bible School Registration – Swartz Creek Church of Christ

Thank you for registering for Vacation Bible School at Swartz Creek church of Christ. We are excited to spend the week learning about God together in a safe, welcoming, and fun environment.

Please complete one registration form per child.

CHILD INFORMATION

Child Full Name

First

Last

contact Guardian) INFORMATION

Preferred Name / Nickname (Optional)

Date of Birth

Age

Grade Completed This School Year

T-Shirt Size (Optional)

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Buddy Request (Optional)

Please list ONE friend your child would like to be grouped with.

Days Attending

PARENT / GUARDIAN INFORMATION

Primary Parent / Guardian Full Name

First

Last

Relationship to Child (Primary Parent / Guardian)

Mobile Phone Number (Primary Parent / Guardian)

Email Address (Primary Parent / Guardian)

Secondary Parent / Guardian (Optional) Full Name

First

Last

Relationship to Child (Secondary Parent / Guardian)

Mobile Phone Number (Secondary Parent / Guardian)

Emergency Contact Full Name

First

Last

Relationship to Child (Emergency Contact)

Phone Number (Emergency Contact)

MEDICAL & SAFETY INFORMATION

Authorized Pickup List

Please list the names of adults authorized to pick up your child from VBS. Optional Note: Identification may be requested at pickup if needed.

Allergies

Food Allergies
Medication Allergies
Environmental Allergies
No Known Allergies

Please explain any allergies or precautions we should be aware of:

Medical Conditions or Health Concerns

Please list any medical conditions or health concerns we should be aware of, including asthma, diabetes, seizures, etc.

Medications Needed During VBS

Yes
No

If yes, please explain medication instructions and any important details:

Special Needs or Accommodations

Please share any learning, behavioral, sensory, mobility, or other accommodations that may help us serve your child well.

Dietary Restrictions

Please list any dietary restrictions:

PERMISSIONS & AGREEMENTS

Photo / Video Permission

Yes, my child may appear in church photos/videos used for church purposes.
No, please do not photograph or video my child.

Medical Emergency Authorization *

I agree

In the event of a medical emergency, I authorize VBS volunteers and church representatives to obtain appropriate medical treatment for my child if I cannot be reached immediately.

Parent / Guardian Agreement *

I agree

I confirm that the information provided on this form is accurate and complete to the best of my knowledge.

OPTIONAL INFORMATION

Church Home / Visitor Information

We attend Swartz Creek church of Christ
We regularly attend another congregation
We are visiting / looking for a church home (Optional)

If you attend another congregation, please list it below:

Parent Volunteer Interest (Optional)

Yes

I would be interested in helping or volunteering during VBS.

If interested, please provide your preferred contact method:

Phone
Email