Bethel Prescott Valley - VBS 2026 Registration

VBS Arctic Blast 2026 Registration - Bethel Church Prescott Valley. June 22-26, 9A-12P

Section 1 -- Parent / Guardian Information

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency Contact Information

First Name

Last Name

Phone Number

First Name

Last Name

Age

Birthdate

Grade (Fall 2026)

Allergies or Medical Conditions

If Medications are required during VBS, please describe.

Special Needs / Notes for Teachers

Photo / Video Permission

Yes, my child may be included

No

Medical Release Agreement

I authorize Bethel Church Prescott Valley to seek medical attention if needed