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VBS Registration
* Indicates required question
Child's Name
*
Your answer
Parent/Guardian Name
*
Your answer
Full Address
*
Your answer
Mailing Address (if different)
Your answer
Phone
*
Your answer
Email
*
Your answer
Date of Birth and Last Grade Completed in School
*
Your answer
Medical Information - Medical or other info we need to know. (Please include any food allergies).
Your answer
Emergency Contacts (other than listed above)
*
Your answer
Dismissal Information (Who may pick up your child from VBS?)
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Your answer
Other: Does your child attend church? If so, where?
Your answer
If your child is visiting our church, who is he/she a guest of?
Your answer
May we have permission to photograph your child?
*
Yes
No
May we have permission to use your child's photograph for the purpose of promotion?
*
Yes
No
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