Lakewood Baptist Church VBS Registration
June 4 - 8, 2017 Starts at 5:15 for dinner and ends at 8:30
Student's 1st name
The name they prefer to be called.
Your answer
Student's Last Name
Your answer
Parents/Guardians Name
first & last
Your answer
Address
mailing address including zip code
Your answer
2 Phone Numbers
List numbers which you can be reached at during VBS time.
Your answer
Your answer
Child's Birth Date
Your child should have turned 3 years old before 9/1/2016 to attend VBS.
MM
/
DD
/
YYYY
What grade was your child in for the 2016-2017 school year?
What grade did the student just complete?
Does your child have any allergies or medical conditions we should be aware of?
Your answer
Is their anyone who we should be aware of who may NOT pick up your child?
This is for custody/safety/legal issues.
Your answer
If you are a guest, who are you a guest of?
Your answer
Is there any other pertinent information you would like for us to know about your child?
Your answer
May we publish your child's picture for promotional purposes on the church website and/or Facebook page?
If yes, you do not have to reply to this question.
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