Pompey Community Church - NY

Participants Information

Please fill out a form for each child participating in PCC's VBS. You will be prompted to fill in the parent's information on the first child only.

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Birthdate

Gender

Does your child have any allergies?

Yes

No

Allergies

Please enter the grade the child is going to be in 2026-2027 School Year:

Grade

Parent Information:

First Name

Last Name

Any concerns or other information to share with leadership to ensure your child, along with everyone, has a great week:

Photograph Agreement: I agree to allow pictures to be taken of my child that will be used on social media & the PCC website. No names will be associated with my child.

Yes

No

Have you already registered another child?

Yes

No

Email

Phone Number

Is your address different than your child's?

Yes

No

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Do you have a home church?

Yes

No

Home Church:

Vacation Bible School Registration

Participants Information

Parent Information:

About

Service Times

Contact Info

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