Knox VBS 2018- Rolling River Rampage
Please submit 1 form for each participant.
Name of child *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Grade they will be entering September 2018 *
Please list any special learning needs, allergies, or medical needs the VBS staff should be aware of to better help this child.
Your answer
Name of parent/guardian *
Your answer
Parent/Guardian Phone Number (s) *
Your answer
Parent/Guardian email (Needed to receive confirmation email) *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone number (If parent/guardian can't be reached) *
Your answer
Do we have permission to take photos/video of your child for VBS related projects that may be posted on the Church Website? *
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