River Road Church, Baptist - Vacation Bible School Registration 2019
VBS: July 15-19, 2019, 9AM - Noon
Please complete this form for each child you are registering. (If you are registering more than one child, you must fill out this form individually.) If you have any questions, please email vbs@rrcb.org. Please register by June 30. (www.rrcb.org/vbs)
Child's Information
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's Birthday *
MM/DD/YEAR (e.g. 03/27/2009)
Your answer
School Grade Completed in June *
Note: Children who completed JK will be in a VBS class with children who completed Kindergarten.
Does your child have any allergies or special needs? *
If you answered yes to the above question, please list or describe them below.
Your answer
I grant permission to River Road Church, Baptist to use any photographs, motion pictures, recordings, or any other record of this event for legitimate purpose. *
Please select your Yes or No choice, and initial in the Other field.
Parent & Emergency Contact Information
Parent/Guardian Name *
First and Last Names
Your answer
Parent/Guardian Street Address *
Your answer
Parent/Gardian City, State, & Zip Code *
ex: Richmond, VA 23229
Your answer
Parent/Guardian Preferred Phone Number *
Please include area code.
Your answer
Parent/Guardian Alternate Phone Number *
Please include area code.
Your answer
Parent/Guardian Email *
Your answer
May we add your email address to our Children's mailing list so you can learn about other children's events and activities at River Road Church, Baptist? *
Is your family looking for a church home, and would you like the Minister to Children to contact you?
Emergency Contact Name *
Person other than parent/guardian.
Your answer
Emergency Contact Phone Number *
Please include area code.
Your answer
Emergency Contact Relationship to Child *
Your answer
I understand that I am required to fill out a Medical Release Form for the child I am registering. [Please initial.] *
Please print this form and bring it on the first day of VBS: https://rrcb.org/wp-content/uploads/2018/04/Medical-Release-Form.pdf
Your answer
Childcare is provided for volunteers with children under 4.
Are you willing to volunteer during VBS? *
If yes, what days you're available?
Please check all that apply.
Do you have a child under 4 who will need childcare?
Do you have a middle school or high school student that would like to volunteer? *
I understand that if I participate as a volunteer, I will be required to fill out a background check form. [Please initial.] *
Your answer
Never submit passwords through Google Forms.
This form was created inside of River Road Church, Baptist. Report Abuse - Terms of Service