Vacation Bible School June 22-26 – Registration Now Open! Posted April 2, 2026 VBS 2026 Registration The Great Journey with Jesus, Through the Church Year! ~~~~~~~~~~~~~~ Date: June 22 – 26 Ages: 4 yr. olds through rising 5th graders Hours: 9:00 a.m. to 12 noon ~~~~~~~~~~~~~~~ **For volunteer information/questions, please email Kelly Rush at Kelly4VT@gmail.com ** VBS Registration Form 2026 URLThis field is for validation purposes and should be left unchanged.Please register your child for the rising grade level as of Fall 2026. No friend requests will be accepted.Cost ** No Refunds after June 1 **How many children are you enrolling?*Cost is $75 for the 1st child, and $50 for each additional child.1 Child2 Children3 Children4 ChildrenI would also like to purchase... Nothing, thank you, just the registration. The Great Journey with Jesus music CD. Total $0.00 Student InformationChild's Full Name*Child's Grade Level as of Fall 2026*Child's T-Shirt Size*Youth SYouth MYouth LAdult SAdult MAdult LAdult XLAdult XXLSex*MaleFemale2nd Child2nd Child's Full Name*2nd Child's Grade Level as of Fall 2026*2nd Child's T-Shirt Size*Youth SYouth MYouth LAdult XSAdult SAdult MAdult LAdult XLAdult XXLGender*MaleFemale3rd Child3rd Child's Full Name*3rd Child's Grade Level as of Fall 2026*3rd Child's T-Shirt Size*Youth SYouth MYouth LAdult XSAdult SAdult MAdult LAdult XLAdult XXLGender*MaleFemale4th Child4th Child's Full Name*4th Child's Grade Level as of Fall 2026*4th Child's T-Shirt Size*Youth SYouth MYouth LAdult SAdult MAdult LAdult XLGender*MaleFemaleAdditional InformationName(s) of Parent(s) or Guardian(s)*Parent Email* Address of Parent(s) or Guardian(s)* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent Home/Cell PhoneParent Work PhoneName of Home Church*Emergency Contact Name*Please name another person other than parents to be notified in an emergency.Emergency Contact Phone*Who may pick up your children from VBS?*Please name the pick-up people.Allergy InformationAllergies: Please explain pertinent allergy information in the box below.Medical/Allergy ReleaseMedical/Allergy Release*Please indicate your agreement with the following medical release: In the event of an emergency or non-emergency situation in which medical treatment is required for my child as a result of participation with the 2026 Vacation Bible School program held at St. Theresa, Ashburn, VA, I authorize the on-site adult leaders, volunteers, and staff members to act as my agents and thereby consent to emergency medical treatment. I understand that every reasonable attempt will be made to contact me in the event of an emergency. I agree with the above medical release. Name of parent digitally signing medical release*Please type your name.Student Drop Off/Pick Up Information*Students cannot be dropped off prior to 8:50AM. Students must be picked up promptly at 12:00PM. PLEASE NOTE: **Only drop off exception is the first day of VBS. Drop off will be at 8:40AM**. I have read and understand the above drop off/pick up procedures. Would you like to volunteer? (registration discount given for adult volunteer)*NoYesYour Registration is Incomplete Without Payment** No Refunds after June 1 **
