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
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