2022 Vacation Bible School Registration
Vacation Bible School Registration for Eastside Baptist Church
June 26-30
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Email *
Child #1 First and Last Name: *
Child #1 Age: *
Child #1 Grade Completed: *
Child #2 First and Last Name:
Child #2 Age:
Child #2 Grade Completed:
Child #3 First and Last Name:
Child #3 Age:
Child #3 Grade Completed:
Child #4 First and Last Name:
Child #4 Age:
Child #4 Grade Completed:
Parent First and Last Name: *
Address:
City, State, Zip Code:
Home Phone #:
Cell Phone #: *
1st Emergency Contact Name: *
1st Emergency Contact Number: *
2nd Emergency Contact Name:
2nd Emergency Contact Number:
Allergies/Medical Conditions:
1st Authorized Pick-up Name: *
1st Authorized Pick-up Number: *
2nd Authorized Pick-up Name:
2nd Authorized Pick-up Number:
Do you give Eastside Baptist Church VBS leaders permission to photograph and or video your child/children for any lawful purpose associated with this VBS program? *
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