KINGDOM QUEST 2026

Mon - Fri, July 13th - 17th, 6PM - 8:15PM | Register your Elementary Child for a fun week of VBS Kids Camp on a epic journey to discover God's Kingdom. This is a free camp provided by West Main Church of Christ 1701 W. Main ST. Medford OR.

Date

*

Childs Name

*

Grade child will be in this next school year.

*

Please select one option.

Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

Parents/Guardian Names

*

Parent #1/Guardian Phone #

*

Parent #2/Guardian Phone #

Additional Emergency Contact - Name and #

*

Email

*

This address will receive a confirmation email

Address

List anyone who will be picking up child other than Parents/Guardian listed above (and relationship to the child.)

Does your child have any FOOD ALLERGIES?

*

Please select all that apply.

YES NO

If YES, please list.

Does your child have any SPECIAL NEEDS, MEDICAL CONDITIONS, or REQUIRE ANY ACCOMODATIONS we should know to help them have the best experience?

*

Please select all that apply.

YES NO

If YES, please explain.

I give my permission for my child's photo/video to be in a short video created for parents and church family.

*

Please select one option.

YES NO

Description

Mon - Fri, July 13th - 17th, 6PM - 8:15PM

Register your Elementary Child for a fun week of VBS Kids Camp on a epic journey to discover God's Kingdom. This is a free camp provided by West Main Church of Christ 1701 W. Main ST. Medford OR.

Please Fix the Following

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