TCPC VBS Registration Form
Join us at Shipwrecked: Rescued By Jesus
When: July 16-20, 2018. Monday-Friday, 9:00 AM- 11:30 AM.
Who: 4 year olds (By September 30) - 5th graders *Must Be Potty Trained*
Cost: $5 Per Child
If submitted online, your $5 payment will be due on the first day of VBS
Parent's Name: *
Your answer
Parent's Address: *
Your answer
Parent's Phone Numbers (Cell, Home, Work): *
Your answer
Emergency Contact Info (Name, Relationship to Child & Phone Number): *
Your answer
Please list all people authorized to pick up your child/children from VBS: *
Your answer
Please list all of your children below who will be attending VBS. Include their most recent grade completed and their birthdays: *
Your answer
Please explain any allergies your child/children have:
Your answer
Please explain any special learning or sensory needs your child/children may have:
Your answer
Select the box if you DO NOT want your child's photograph to be taken
In the event of an emergency and I cannot be reached, the staff at VBS has my permission to seek medical attention for my child. (Please type your name and the date as an indication of consent.) *
Your answer
Submit
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