Rural Southeast VBS

Registration

* Indicates REQUIRED field.

Did you attend last year?
How did you hear about us?
* Date of Birth
* First Name
* Last Name
* Street Address
* City
* State
* Zip
* Home Phone
* Email Address
* Please Re-Enter Email Address
Parent 1 Name
Parent 1 Phone
Parent 2 Name
Parent 2 Phone
Emergency Contact Name
Emergency Contact Phone
T-Shirt Size
Allergies or Medical Conditions?
Doctor Name
Doctor Phone
Last Grade Completed
Home Church
Do you give us permission to use photos of your child on our website or Facebook page?
Will your child be attending story hour at the Shubert Library following VBS?
Additional Information we should know?

Phone: 1-402-245-0150
Rural Southeast VBS IT Support
McKayla Ewers

Do you know of any other youth camps coming up and would like to share the information here? Contact me at info@ruralsoutheastvbs.worthyofpraise.org Read More »