Mountain Valley Church

VBS 2026 - Illumination Station

Child's First Name

Last Name

Birthdate

Gender

Grade (completed this year)

Allergies

My child would like to be in the same group as:

Parent/Guardian Information

Parent/Guardian First Name

Last Name

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

How did you hear about MVC's VBS?

Do you attend church somewhere?

Media Consent

I understand that my child's image may be included in a video or in photographs that may be made by MVC. I consent that my child's image may appear on videos or pictures and posted on social media.

Signature