Galaxy VBS Registration 2026
June 28-30, 6:15-8:30PM | Please fill out this form and click submit.
Please complete once per family.
Parent or Guardian Name
*
Email
*
This address will receive a confirmation email
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent/Guardian Cell Phone Number
*
Home Church
*
Who will pick up your child(ren) at 8:30pm?
*
Emergency Contact
*
Emergency Contact Phone Number
*
Emergency contact's relationship to child(ren)
*
Do you give permission for your child(ren) to be photographed or filmed for VBS use and ministry promotional purposes.
*
Please select one option.
Yes
No
Select Option
Yes
No
Complete the following for child #1.
Name
*
Sex
*
Age
*
Birthday
*
Grade Completed
*
Allergies or special needs
*
Shirt Size
*
Please select one option.
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
Select Option
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
If you are registering as a guest, who are you a guest of?
*
Complete the following for child #2.
Name
Sex
Age
Birthday
Grade Completed
Allergies or special needs
Shirt size
Please select one option.
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
Select Option
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
If you are registering as a guest, who are you a guest of?
Complete the following for child #3.
Name
Sex
Age
Birthday
Grade Completed
Allergies or special needs
Shirt size
Please select one option.
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
Select Option
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
If you are registering as a guest, who are you a guest of?
Complete the following for child #4.
Name
Sex
Age
Birthday
Grade completed
Allergies or special needs
Shirt size
Please select one option.
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
Select Option
Youth XS, 4-5
Youth S, 6-8
Youth M, 10-12
Youth L, 14-16
Youth XL, 18-20
If you are registering as a guest, who are you a guest of?
Submit
Description
June 28-30, 6:15-8:30PM
Please fill out this form and click submit.
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