Vacation Bible School July 21-25, 2025 (6:30pm - 8:00pm)
STUDENT REGISTRATION FORM
Program Contact Information: (973) 923-7658 or stjohnscbc@gmail.com
Student's First and Last Name
*
Please Select Child or Adult
Kid $5.00 (4 or more one child free)
Adult $10.00
If Child: Age / Birth Date / Grade / Parent or Guardian Name(s)
*
Student Cell # (or) Home Phone #
Email Address
Preferred Contact Method (please select only one)
*
Phone
Email
In Person
Cost: Kids (FREE) / Adults ($10): Amount paid for this registration:
*
Emergency Contact 1 (and) Phone #
*
Emergency Contact 2 (and) Phone #
Allergies or Special Needs (If there are none, please indicate N/A)
*
Who may pick-up your child at the end of each VBS day? Name and Relationship to child
*
Submit
