VBS Registration

Vacation Bible School 2018 Registration. Separate registration for each child. Please provide all information.

Child's Name: *

First

Last

Parent/Guardian Name *

First

Last

Address: *

Mailing Address (if different):

Phone Numbers:

Home Number

Phone Numbers:

Work Number

Phone Numbers:

Cell Phone

Email:

Age Information: *

Child's Birth date

Last grade completed in school

Medical Information:

Medical or other information we need to know. (Include any food allergies.)

Emergency Contacts: *

Name

Emergency Contact

Phone Numbers(s)

Emergency Contact

Name

Emergency Contact

Phone Number(s)

Dismissal Information: *

Who may pick up your child at the end of each VBS day?

Other Information:

Do you attend Sunday School? If so, where?

Other Info

If you are visiting our church, who are you a guest of?

May we have permission to photograph your child?

May we have permission to use your child's photo in church promotional publications?

Message

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