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Participant Registration

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Registro en Español

Westminster PCA

Location

2801 W Riverside Ave

Muncie, IN 47304

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Contact Elizabeth Imel:

765-602-0048

eimel@newlifepca.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Home Church Affiliation

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Country

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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How did you find out about Space Mission VBS 2026?

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Children who are 4 years old by June 1st through age 14 (or 7th grade) are welcome to register at VBS.
5th graders (age 11 by June 1st) may join the combined 4th/5th grade class at the church or join the J-Walkers, who will work on service projects at REACH Yorktown. This choice must be made at the registration and will remain the same for the duration of the week.

Those leaving 5th grade may choose to participate in the 4th/5th grade class. If that is the choice, please indicate "4th/5th" as their grade below. If you wish to register a middle schooler (grades 5-7) to participate in J-Walkers, please indicate "J-Walkers" as their grade below.

Grade Leaving

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Grade Leaving

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Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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Do you have friends that you wish for your child to be placed in a group with? We cannot promise that all requests will be fulfilled.

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Comments

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I give permission for my child to appear in photos while participating at VBS with the understanding that such photos may appear in church publications, including websites, directories, brochures, and promotional videos.

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By registering your child for VBS 2026, you are agreeing to the following statements:

I consent to any x-ray examination, anesthetic, medical, or surgical diagnosis or treatment and hospital care under the general or special supervision and upon the advice of or to be rendered by a physician and surgeon licensed under the Medical Practice Act for my child. This authority also extends to any x-ray examination, anesthetic, dental, or surgical diagnosis or treatment and hospital care by a dentist licensed under the Dental Practice Act for my child. I further agree to pay all charges for the dental, medical, or hospital care or treatment.

As parent or legal guardian, I am responsible for the health care decisions of my child and am authorized to consent to the services to be rendered. I represent that my consent to and agreement to pay for the dental, medical, or hospital care or treatment to be rendered to my child is legally sufficient and that no consent from any other person is required.

I consent to my child's participation in Vacation Bible School and I expressly wave any claim for compensation or liability for any injuries or illnesses sustained during my student's participation.

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