VBS Registration Form
Child's Name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Mailing Address (if different)
Your answer
Home Phone Number *
Your answer
Cell Phone Number *
Your answer
Email
Your answer
What is your child's birth date? *
MM
/
DD
/
YYYY
What is the last school grade your child completed? *
Your answer
Does your child have any medical needs (including allergies) or other information we need to know? *
Your answer
Please list names and phone numbers of additional emergency contacts (other than the Parent/Guardian listed above) *
Your answer
Who may pick your child up at the end of VBS each evening? *
Your answer
Does your child attend Sunday School? 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? *
May we have permission to use your child's photograph for the purpose of promotion? *
Each child who is registered BEFORE June 9th will receive a FREE T-shirt. Please select your child's size:
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