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Participant Registration

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Prince of Peace Lutheran Church

Location

8304 Old Keene Mill Rd

Springfield, VA 22152-1640

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Contact Alex Lillis:

703-451-5855

alex.lillis@poplc.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Would you like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

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Parent/Guardian #2 Email

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Would Parent/Guardian #2 like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

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Contact Phone 1

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Contact Phone 2

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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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Home Church Affiliation

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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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Emergency contact email

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Comments

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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

Which session will they be attending?

First Name

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Last Name

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Please select the Grade your child will be entering in the Fall of 2026.

Vacation Bible School participant spots are open to children entering Grades 1-6 in the Fall of 2026. Children younger than this are invited to register for our POP School Camp, and children older than this are invited to register as a VBS volunteer.

Grade Entering

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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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Has this child been baptized?

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Does Prince of Peace have your permission to use your child(ren)'s photograph in any of its publications, including both printed and digital?

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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