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Pleasantville EVBS
Pleasantville's Ecumenical Vacation Bible School
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Registration Information
Online Registration Form
Volunteer
Teen Helpers
How to Help
Mr. Chris
Participating Congregations
Online Registration Form
EVBS Registration
Parent / Guardian Information
Primary Parent Contact Name
*
First
Last
Primary Email
*
Secondary Email
Primary Daytime Phone
*
Phone Type
*
Mobile
Home Landline
Work Phone
EVBS is allowed to send me text messages.
Secondary Phone
Secondary Phone Type
Mobile
Home Landline
Work Phone
EVBS is allowed to send me text messages.
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Church Affiliation
*
St. John's Episcopal Church
Pleasantville Presbyterian Church
Holy Rosary Parish
Holy Innocents Parish
Emanuel Evangelical Lutheran Church
The United Methodist Church in Pleasantville
Other - We're New!
Child Registration
Register Students
Child Name
Edit
Delete
There are no
Children.
Add Child
Maximum number of children reached.
Emergency Contact Information
Emergency Contact Name
*
First
Last
Emergency Contact Relationship
Emergency Contact Phone
*
Physician Name
*
Physician Phone
*
Registration Fee
Consent
*
By checking the box below you are giving permission for your child(ren) to participate in Pleasantville's Ecumenical Vacation Bible School (EVBS) and you understand and accept all risks to participating in the planned activities.
Pleasantville EVBS may take pictures or videos of your child during the course of the program. These photos will be shared in the Thursday evening program and may be used for promotional purposes in the future.
I agree
Payment Method
Pay Online
Mail a Check
Registration Fee
Price:
$35.00
Registration Cost
Pay Online Using Square
We need volunteers!
I can volunteer the whole week
I can volunteer Monday morning
I can volunteer Thursday evening
Adult and high school volunteers are needed to teach, supervise, run outdoor games, prepare daily snacks, set-up, clean-up and more.
Child Name
*
First
Last
Birthdate
*
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Grade in Sept '19
*
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
T-Shirt Size
*
XS
Small
Medium
Large
XL
2XL
3XL
T-Shirt Size
*
Youth Sized
Adult Sized
Allergies?
*
Youth Group Participants
Youth Group (6-8th grade) parents please check the box below to indicate permission for your child to walk with the group to some of the other churches and to participate in our mission projects.
I understand and agree.
Parent / Guardian Name
First
Last
Primary Contact Phone
Primary Contact Email
Church Affiliation
Pediatrician Name
Pediatrician Phone
Emergency Contact Name
First
Last
Emergency Contact Phone
Church Affiliation
St. John's Episcopal Church
Pleasantville Presbyterian Church
Holy Rosary Parish
Holy Innocents Parish
Emanuel Evangelical Lutheran Church
The United Methodist Church in Pleasantville
Other - We're New!