Geneva Church 2026 VBS Registration Discovery on Adventure Island Please enable JavaScript in your browser to complete this form.Child InformationName *FirstLastDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grade/class completed June 2026 *PreschoolKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradePlease indicated which grade your child did or will complete in June 2025. Name of School *We try to group children with their friends whenever possible. Please let us know who your child will enjoy being in a group with. Please note – preschool aged children are all together in their own group. Parent/Guardian InformationName *FirstLastEmail *Phone *Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmergency ContactName *FirstLastPhone *Medical Concerns or Special Needs situations *Please let us know of any allergies, special learning or medical needs, or anything else we should be aware of to help your child have the best possible experience at VBS.Submit