Stonehill SDA Church VBS 2019 Child Registration Form
Please fill out a separate form for each child participating
Child's Name
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Child's Age
Your answer
Child's Sex
Female
Male
Clear selection
Parent's/Guardian's Name 1
Your answer
Home Address
Your answer
Home/Cell Phone
Your answer
Parent/Guardian email address
Your answer
Custodial Arrangement
Your answer
Allergies or other medical conditions
Your answer
In case of emergency, contact
Your answer
Emergency Phone
Your answer
Emergency Contact relationship to the Child
Your answer
I give permission to call 911 in case of Emergency
Yes
No
Clear selection
Photographs will be taken during VBS. My signature indicates I am giving permission for my child's photo to be taken
Your answer
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