2025 Beavertown GMC VBS Registration Form

June 17-20, 2024, 6pm-8:15pm | Please fill out the form completely and then click "Submit"!

Please note, you will need to fill out a registration form for each child who is planning to attend.

If you have any questions, please contact our registrar, Julie Witmer, by call or text @ 570-541-8542.

Child's Name:

*

Child's Age Range (Check One):

*

Please select all that apply.

3-4 Years 5-6 Years 7-8 Years 9-10 Years 11-12 Years 13-18 Years

Parent/Guardian's Name:

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Transportation:

*

Please select one option.

Yes, I want bus transportation! No, we will provide our own transportation.

Which town is closest to your address?

*

Please select one option.

Beavertown Beaver Springs McClure Penn's Creek Troxelville Middleburg My address is not near any of these towns

Which days will you be attending? (Choose all that apply.)

*

Please select all that apply.

All of them! Tuesday Wednesday Thursday Friday

Please list any food allergies or other things of which we should be aware:

Description

June 17-20, 2024, 6pm-8:15pm

Please fill out the form completely and then click "Submit"!

Please note, you will need to fill out a registration form for each child who is planning to attend.

If you have any questions, please contact our registrar, Julie Witmer, by call or text @ 570-541-8542.

Please Fix the Following

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