Register for the 2017 VBS Program. If you have any questions please feel free to call or contact us. Looking forward to seeing you and your children for an awesome week July 24th – 28th! Child's Name* First Last Please fill out a separate form for each childAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Child's Age*Grade Entering in the Fall*K4/preschoolKindergartenFirstSecondThirdFourthFifthEmergency Contact InformationEmergency Contact* First Last Emergency Phone*Mother's Name First Last Father's Name First Last Allergies or Other Medical ConditionsMore InformationYour Home ChurchFriend Your Child Would Like to be with at VBSHow did you Hear About VBS at Lakes?*A Friend of Family Invited UsThe Walked Lake Memorial Day ParadeI Attend Lakes Bible ChurchSaw a Lakes Sign or FlyerThe InternetAre you interested in parenting discussion?*Yes - I'll Need Child CareYes - I Don't Need Child CareNo This iframe contains the logic required to handle AJAX powered Gravity Forms.