2018 VBS at BBC Registration Form
Registration for ages 4 thru 6th Graders. JULY 15th - 19th
VBS 2018 REGISTRATION
CHILD'S LAST NAME *
Your answer
FIRST NAME *
Your answer
CHILD'S CURRENT AGE? *
Your answer
LAST GRADE COMPLETED *
NAME OF PARENT(S)/GUARDIAN *
Your answer
ADDRESS *
Your answer
CITY *
Your answer
STATE *
Your answer
ZIP CODE *
Your answer
PRIMARY PHONE NO. *
Your answer
SECONDARY PHONE NO. *
Your answer
E-MAIL ADDRESS *
Your answer
EMERGENCY CONTACT PERSON *
Your answer
EMERGENCY CONTACT NO. *
Your answer
WHO CAN PICK UP CHILD? *
Your answer
WILL HE/SHE ATTEND WITH ANOTHER CHILD? IF SO, WHO? *
Your answer
WILL HE/SHE ATTEND WITH A VBS VOLUNTEER? IF SO, WHO? *
Your answer
CHURCH YOU NORMALLY ATTEND?
Your answer
DOES CHILD HAVE A SPECIAL PHYSICAL/MEDICAL NEED, OR ALLERGY? *
Please explain.
Your answer
I give Bedico Baptist Church permission to use and/or publish my child's/grandchild's photo in BBC's promotional items (website, newsletter, advertisement, etc.).
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