2024 VBS Registration Form
June 17-21, 2024 | Please fill out the following form to register your child for VBS. This form may be used for all children pre-k through 5th grade.
For volunteers, crew leaders or any adults wanting to participate, go to ojaipc.org and complete the Volunteer Form on the '24 VBS Tab
Participants Name
*
Birthday
*
Grade Entering Fall 2024
*
Please select one option.
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
Select Option
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
T-shirt size
*
Please select all that apply.
child XS
Child S
Child M
Child L
Adult XS
Adult S
Adult M
Adult L
Allergies
Parent 1 Name
*
Email
*
This address will receive a confirmation email
Cell Phone
*
Address
*
--
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 2 Name
Address
--
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
Cell Phone
Payment
$45.00
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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
Submit
Description
June 17-21, 2024
Please fill out the following form to register your child for VBS. This form may be used for all children pre-k through 5th grade.
For volunteers, crew leaders or any adults wanting to participate, go to ojaipc.org and complete the Volunteer Form on the '24 VBS Tab
×
Please Fix the Following