VBS REGISTRATION - 2018
June 4-8, 2018 9 a.m. - Noon 3 yrs. old - 5th Grade
Child's Name *
Your answer
Address *
Your answer
Home Phone/Cell Number *
Your answer
Last School Grade Completed *
Child's Age *
Your answer
Emergency Contact Phone # *
Your answer
Mother's Name
Your answer
Father's Name
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Other/Guardian
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Allergies/Medical Conditions
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Name of Home Church
Your answer
Consent: I consent for my minor child(ren) to the use by Christ's Community Church of photographs and video recordings made of said minor while participating in activities or using services without further compensation and agree that all such materials, including negatives, are the sole property of Christ's Community Church.
SIGNATURE OF PARENT/LEGAL GUARDIAN *
Your answer
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