VBS 2022 Registration Form

EVENT DETAILS
VBS June 13-16, 2022
9:00AM - 12 Noon

Woodbridge Community Church
Address: 5000 Barranca Parkway
City: Irvine, CA 92604

Free Admission/Registration
ends May 22, 2022. After May 22, cost is $40 per child.

Should you have any questions
or concerns. Please call the Church Office (949) 552-1101 for more information.

Please fill out this form and click submit.

Parent / Guardian Information

Name of Parent / Guardian (First and Last Name)

Name of Parent / Guardian (First and Last Name) if not already provided.

Address

Home / Cell Phone

Work Phone

Emergency Contact

Home Email

This address will receive a confirmation email

Home Church

Children Information

1st Child's First & Last Name

1st Child's Birthdate (mm/dd/yyyy)

1st Child's Age

1st Childs Grade Level (Must Have Completed Kindergarten)

Please select one option.

1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Special Needs of Child (learning disability, medications, food allergies, etc.)

2nd Child's First & Last Name (if applicable)

2nd Child's Birthdate (mm/dd/yyyy) (if applicable)

2nd Child's Age (if applicable)

2nd Childs Grade Level (Must Have Completed Kindergarten) (if applicable)

Please select one option.

1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Special Needs of Child (learning disability, medications, food allergies, etc.) (if applicable)

3rd Child's First & Last Name (if applicable)

3rd Child's Birthdate (mm/dd/yyyy) (if applicable)

3rd Child's Age (if applicable)

3rd Childs Grade Level (Must Have Completed Kindergarten) (if applicable)

Please select one option.

1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Special Needs of Child (learning disability, medications, food allergies, etc.) (if applicable)

Registration: FREE registration from April 24th - May 22nd. After May 22nd the cost of registration is $40.00 per child. Due to limited space Woodbridge Community Church recommends that you register as soon as possible.

VBS 2022 Registration Form

Description

Please Fix the Following