VBS Registration
First Baptist Church of Palmyra is hosting Vacation Bible School for students ages 4-12. We will have music, crafts, snacks, games, and gospel saturated lessons. Please complete this form for each child participating in VBS. Each child must have this completed by a parent or guardian prior to enrollment.
Email *
Child's Name *
Grade just completed: *
Age *
Address *
Father/Guardian name *
Mother/Guardian name *
Father/Guardian cell phone *
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Mother/Guardian cell phone *
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Father/Guardian email address *
Mother/Guardian email address *
Emergency contact if parents or guardians cannot be reached *
Secondary emergency contact if parents or guardians cannot be reached
Emergency contact phone *
Format ###-###-####
Medical or food allergy information *
Please indicate any special needs or dietary restrictions
What are the names of people to whom we can release your child? *
We will not release your child to anyone other than the parents and guardians listed above or those listed below
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