Town Creek Baptist Church | Leland, NC

Registration is now open for "Illumination Station" VBS at Town Creek! VBS is June 14-18 with closing ceremonies on June 19. Each evening, we will have dinner at 5:30pm, and then VBS is 6:00-8:30pm. VBS is open to children age 3 (and potty trained) to those who have completed sixth grade.

Use the form below to sign your child up for VBS. Please complete a separate form for each child you would like to register for VBS. As you can see, this year's theme is "Illumination Station," and keep in mind, there may be strobe lights, and other lighting effects used in the worship rally that could trigger seizures in sensitive individuals. Please let us know in the Medical Information section if your child could use special accommodations with regard to light sensitivity.

Child's First Name

Child's Last Name

Parent/Guardian First Name

Parent/Guardian Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Cell Phone Number

Home Phone Number

Birthdate

Grade Last Completed

Medical Information (Including Light Sensitivity, Food Allergies)

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Number

Dismissal Information - Who may pick up your child at the end of VBS each day?

Does your child attend church regularly?

Yes

Somewhat

Name of church your child attends

If your child is a guest, who is he / she a guest of?

Please note that all VBS participants may be photographed and or videoed at different times throughout the week. This footage may be used in promotional materials for Town Creek Baptist Church including but not limited to our app, website, social media, and print publications.

I have read the above photography notice and consent to the photographing of my child.

Yes

Please describe any prayer requests you may have. This will be kept confidential between our VBS leadership and our pastors.

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