Vacation Bible School 2026

Register for EMERALD CROSSING

Whiting Bible Church VBS

Monday - Friday | July 20th - 24th | 6pm - 8:15pm

95 Lacey Rd, Whiting, NJ 08759

Parent/Guardian Name

Address

City

State

Zip Code

Emergency Contact #

Who is authorized to pick up your child(ren)?

How many children are you registering?

Child 1 Name

Gender

Age

Date of Birth

Allergies or medical concerns

Child1 Name

Child2 Name

Gender

Age

Date of Birth

Allergies or medical concerns

Alergies? Medical Concerns?

Child1 Name

Child2 Name

Child3 Name

Gender

Age

Date of Birth

Allergies or medical concerns

Alergies? Medical Concerns?

Child1 Name

Child2 Name

Child3 Name

Child4 Name

Gender

Age

Date of Birth

Allergies or medical concerns

Alergies? Medical Concerns?

PERMISSION TO USE IMAGES AND VIDEO
I hereby grant permission for Whiting Bible Church to record sounds, images, or video of the child(ren) named on this form, while attending this VBS program. I also give permission for Whiting Bible Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Whiting Bible Church in relation to this VBS program.

Comments / Questions

Please know that your personal information will not be shared with any entities beyond Whiting Bible Church. Email is our preferred method of contacting parents regarding upcoming Children's events at WBC. Phone will only be used for contact when necessary.

SUBMIT form when completed and wait for the confirmation. Thank you!!