Virtual Reality Camp

Virtual Reality (VR) Camp will be held June 8-9, 2026, for students who will enter Grade 2 - 6 in Fall 2026.

This camp provides a variety of VR experiences, ranging from games to history to exploration to art to STEM to exercise, and gives students an introduction on how to use VR and create with it!

Dates: June 8 - 9, 2026
Time: 10 a.m. - 3 p.m. each day
Cost: $125 per student.

Lunch will be provided each day. Please indicate on this form if there are any dietary restrictions we need to be aware of.

You may only register one family with this form. If you need to register others, please fill out this form once for each family.

All fields are required. Please contact Brian Klebig with questions.

Parent/Guardian Name Parent/Guardian Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent/Guardian Phone
Parent/Guardian Email
Number of children attending

Number of children attending One ($125) Two ($250) Three ($375) Four ($500)
Student #1 Name Student #1 Name First Last
Student #1 Date of Birth Student #1 Date of Birth / MM / DD YYYY
Student #1 School Name / City
Student #1 Grade (Fall 2026)

Student #1 Grade (Fall 2026) 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade
Student #2 Name Student #2 Name First Last
Student #2 Date of Birth Student #2 Date of Birth / MM / DD YYYY
Student #2 School Name / City
Student #2 Grade (Fall 2026)

Student #2 Grade (Fall 2026) 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade
Student #3 Name Student #3 Name First Last
Student #3 Date of Birth Student #3 Date of Birth / MM / DD YYYY
Student #3 School Name / City
Student #3 Grade (Fall 2026)

Student #3 Grade (Fall 2026) 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade
Student #4 Name Student #4 Name First Last
Student #4 Date of Birth Student #4 Date of Birth / MM / DD YYYY
Student #4 School Name / City
Student #4 Grade (Fall 2026)

Student #4 Grade (Fall 2026) 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade
Dietary Restrictions

Lunch will be provided. If any students have dietary restrictions we need to be aware of, please use this field to specify the name of the student and the restriction.
Liability Waiver

I give permission for my child/children, specified on this form, to attend Bethany Lutheran College’s Virtual Reality Camp. I understand that all reasonable and prudent safety precautions will be taken during the event and I understand the counselors and camp directors will not be held liable in case of accident or injury. I will be responsible for providing insurance for my child/children.
Liability Signature

Draw or Type

Clear

Full Name
Payment

Please be sure to complete your payment on the next page in order to register for this camp. You should receive a confirmation email after payment is received. Registrations without a completed payment will be considered incomplete.
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Virtual Reality Camp

Virtual Reality Camp

Dietary Restrictions

Liability Waiver

Payment

$0

Total

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