Faith Baptist VBS Registration Form
Thank you for registering for our 2017 VBS! Please note that parents/guardians will need to sign a consent form on the first evening of VBS (in addition to this registration form). Fees are $10 per child, or a family max of $30, and can be paid by cash or check at any time prior to VBS. Thank you!.
Parent/Guardian First Name
Your answer
Parent/Guardian Last Name
Your answer
Email Address
Your answer
How did you find out about our VBS?
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Parent/Guardian Phone Number
Your answer
Child 1 Name
Your answer
Child 1 Date of Birth
MM
/
DD
/
YYYY
Grade Child 1 is entering in Fall 2017
Child 2 Name (if applicable)
Your answer
Child 2 Date of Birth (if applicable)
MM
/
DD
/
YYYY
Grade Child-2 is entering in Fall 2017
Child 3 Name (if applicable)
Your answer
Child 3 Date of Birth (if applicable)
MM
/
DD
/
YYYY
Grade Child-3 is entering in Fall 2017
Child 4 Name (if applicable)
Your answer
Child 4 Date of Birth (if applicable)
Your answer
Grade Child-4 is entering in Fall 2017
Does your child(ren) have allergies or special needs?
If yes, please explain:
Your answer
Do you consent to having your child's photo taken and possibly posted on the church's website and/or on social media?
Emergency Contact Name:
Your answer
Emergency Contact relationship to child:
Your answer
Emergency Contact Phone Number:
Your answer
Is your child(ren) up-to-date on all vaccinations?
Name of child(ren)'s Physician:
Your answer
Phone number of child(ren)'s Physician:
Your answer
Submit
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