SonRise National Park VBS > Register

Online Registration

* Indicates REQUIRED field.

Parent Information

Parent Name: (required)
Email: (valid email required)
Address: (required)
City: (required)
Zip: (required)
Day Phone (during VBS): (required)
Emergency Contact (if not you):
Emergency Phone:
Doctor Name:
Doctor Phone:
How did you hear about us?
Church you regularly attend?

Child 1 - All fields required

Name:
Attended Last Year:
Date of Birth:
Allergies:
Entering in Fall:

Child 2 (if any)

Name:
Attended Last Year:
Date of Birth:
Allergies:
Entering in Fall:

Child 3 (if any)

Name:
Attended Last Year:
Date of Birth:
Allergies:
Entering in Fall:

Child 4 (if any)

Name:
Attended Last Year:
Date of Birth:
Allergies:
Entering in Fall:

Additional Comments

Comments for VBS Staff

Get in touch!

Pacific Church of Irvine

15 Orange Tree
Irvine, CA 92618

Phone: 949-552-6774
Fax: 949-552-0860
debra@pacificchurch.com