VBS Registration

For the adult class please fill out name, address, email, phone number and in the information section, let us know if you would like the am or pm session.

2024 Breaker Rock Beach VBS Registration

Parent(s) Full Name(s)(Required)
Child #1 Full Name(Required)
Child #2 Full Name
Child #3 Full Name
Child #4 Full Name
Address(Required)
My son/daughter has permission to participate in the VBS program at Mountain Ridge Bible Chapel. By signing this form, I declare that I am the legal parent/guardian of the minor child/children listed above and authorized to grant such permission. I give permission to Mountain Ridge Bible Chapel to use photographs containing my child/children in the closing program slideshow and on their website.
MM slash DD slash YYYY