VBS Registration Form

Your Name (required)

Your Email (required)

Childs Name (required)

Parents Name (required)

Address (required)

Mailing Address (if different)

Phone Home

Phone Work

Phone Cell

Birth Date (required)

Last Grade Completed in School (required)

Medical Information
Medical or other Information we need to know. (Please include any food Allergies)

Emergency Contacts (other than listed above)
Names and Phone Numbers

Dismissal Information
Who may pick up your child at the end of each VBS Day?

Other Information
Does your child attend Sunday school? if so where?

If your child is visiting our church, who is he a guest of?

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May we have permission to photograph your child?
Select Please Choose Yes or No
YESNO

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May we have permission to use your child's photograph for the purpose of promotion?
Select Please Choose Yes or No
YESNO

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