VBS 2024 Register for Breaker Rock Beach 2024 This is the beginning of the registration process for Liberty Baptist Church's 2024 Annual Vacation Bible School. First, let's get the number of students that will be included in this registration. Each registration is limited to 4 students but you can always submit additional registrations if needed. As always, let us know if you have any questions by reaching us at contact@libertybaptistchurch.org. For technical issues with this form or website, contact our technical team directly at tech@libertybaptistchurch.org.The cost per student is $45.* Price: How many students will be included in this registration?* Student Information Let's get some basic information about the participating student. This will help us place your child in the right group. If your child has allergies, please describe the allergy in detail in the appropriate section below. We'll try to accomodate any special needs. But if there are any potential issues with accommodations before the event, we'll reach out to you to make alternate arrangements. All of the information you share will only be used and accessed by the Liberty Baptist Church Staff at VBS. It will never be shared with anyone else. Your privacy is important to us.Student Name* First Last Age*Entering Grade in Fall 2024*Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthList any allergies below (if applicable) Shirt Size (+$15)*Choose an optionNone Selected (+$0)Small (+$15)Medium (+$15)Large (+$15)X-Large (+$15)Event Shirts The purchase of an event T-Shirt is optional. If you decide to have one, you'll pick it up at the registration desk on the first day of VBS.Student Information Let's get some basic information about the first student. This will help us place your child in the right group. If your child has allergies, please describe the allergy in detail in the appropriate section below. We'll try to accomodate any special needs. But if there are any potential issues with accommodations before the event, we'll reach out to you to make alternate arrangements. All of the information you share will only be used and accessed by the Liberty Baptist Church Staff at VBS. It will never be shared with anyone else. Your privacy is important to us.First Student's Name* First Last First Student's Age*First Student's Entering Grade in Fall 2024*Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthList any allergies for the first student (if applicable) First Student's Shirt Size (+$15)*Choose an optionNone Selected (+$0)Small (+$15)Medium (+$15)Large (+$15)X-Large (+$15)Event Shirts The purchase of an event T-Shirt is optional. If you decide to have one, you'll pick it up at the registration desk on the first day of VBS. Student Information Enter the second student's information below.Second Student's Name* First Last Second Student's Age*Second Student's Entering Grade in Fall 2024*Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthList any allergies for the second student (if applicable) Second Student's Shirt Size (+$15)*Choose an optionNone Selected (+$0)Small (+$15)Medium (+$15)Large (+$15)X-Large (+$15)Event Shirts The purchase of an event T-Shirt is optional. If you decide to have one, you'll pick it up at the registration desk on the first day of VBS. Student Information Enter the third student's information below.Third Student's Name* First Last Third Student's Age*Third Student's Entering Grade in Fall 2024*Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthList any allergies for the third student (if applicable) Third Student's Shirt Size (+$15)*Choose an optionNone Selected (+$0)Small (+$15)Medium (+$15)Large (+$15)X-Large (+$15)Event Shirts The purchase of an event T-Shirt is optional. If you decide to have one, you'll pick it up at the registration desk on the first day of VBS. Student Information Enter the fourth student's information below.Fourth Student's Name* First Last Fourth Student's Age*Fourth Student's Entering Grade in Fall 2024*Select OnePreschoolKindergartenFirstSecondThirdFourthFifthSixthList any allergies for the fourth student (if applicable) Fourth Student's Shirt Size (+$15)*Choose an optionNone Selected (+$0)Small (+$15)Medium (+$15)Large (+$15)X-Large (+$15)Event Shirts The purchase of an event T-Shirt is optional. If you decide to have one, you'll pick it up at the registration desk on the first day of VBS. Your Contact Information We need some basic information about you so that we can reach you before or during the event if needed.Parent Name* First Last Email* Phone*Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Emergency Contact Information We need to have at least one emergency contact for your child. If you would like to designate yourself as the primary emergency contact, enter your information again below.Emergency Contact Information We need to have at least one emergency contact for all students in this registration. If you would like to designate yourself as the primary emergency contact, enter your information again below.Primary Emergency Contact Name* Primary Emergency Contact Phone*Alternate Emergency Contact Information You can optionally add an alternate emergency contact in the event the primary emergency contact is unavailable.Alternate Emergency Contact Name Alternate Emergency Contact Phone Payment Information Finally, please complete the payment fields below to complete your registration. Your payment information is secure and will only be used to process this payment. Credit card information is never stored on our servers and we take your privacy seriously.Credit Card*Card Details Cardholder Name Total $0.00