VBS Registration Form 2026

Child's Name

Child's Age as of June 1, 2026

Grade Child Is Entering in the Fall (Must be K-6th Grade)

What School Does Child Attend?

Name of ONE special friend (in the same grade as your child) that your child might like to be with (optional)

First Name of Parent/Guardian

Last Name of Parent/Guardian

Your Email Address

This address will receive a confirmation email

Phone

Address

How did you hear about Orland Park Church VBS?

Your Church Home

Emergency Contact Name

Emergency Contact Relationship to Child

Emergency Contact Phone

Does your child have any allergies or medical conditions/needs that we need to be aware of? (If yes, explain below)

Yes No

Please list any allergies/medical conditions/mobility needs here:

We aim to be inclusive. Please help us by sharing any attention difficulties, sensory issues, or other challenges that may affect your child.

By submitting this form, I hereby consent that my child, under the supervision of the VBS staff of Orland Park Church, may: 1) Have his/her name, picture, portrait, or photograph used in all forms and media and in all manners, including composite representations, for advertising, trade, or any other lawful purposes, and I waive any right to inspect or approve the finished version(s), including written copy that may be created and appear in connection therewith. 2) Receive emergency medical treatment at a local medical facility as necessary in the event parent, guardian, or emergency contact cannot be reached to arrange for such treatment. 3) Be subject to appropriate decisions by the VBS staff should a behavior issue arise, including, but not limited to, contacting parent/guardian to come pick up their child if behavior issue continues or safety of themselves and/or others cannot be maintained.

VBS Registration Form 2026

Description

Please Fix the Following