Request edit access
Elmhurst Presbyterian Church Superhero VBS! June 18 - 21 5pm - 8pm
Register here for EPC's VBS - Please fill out a separate form for each child
What is your child's name *
Your answer
Child's Age *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Any Allergies or health concerns? If so, please explain *
Your answer
Emergency contact name and phone number *
Your answer
Anything else you'd like us to know about your child? *
Your answer
In case of an emergency, I authorize Elmhurst Presbyterian Church to seek medical attention for my child/children. Elmhurst Presbyterian Church does not assume any financial responsibility, but will provide or arrange for emergency care. By signing this form, you are giving the appropriate VBS personnel authority to call EMS, to transport, or to obtain medical care if you or your emergency contacts cannot be reached or in case of life threatening emergency. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service