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Fall Fun VBS: October 3, 2024
Second Congregational Church
October 3, 2024
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* Indicates required question
Child's Name
*
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Nickname (Optional)
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M/F
*
Male
Female
Birthdate
*
MM
/
DD
/
YYYY
School Currently Attending
*
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Grade Fall 2024
*
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If siblings attending please list each sibling below
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Parent/Guardian Name
*
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Street Address
*
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City
*
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State
*
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Zip Code
*
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Parent/Guardian Cell Phone
*
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Parent/Guardian Email
*
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Emergency Contact Name
*
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Emergency Contact Cell Phone
*
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Emergency Contact Relationship to Registrant
*
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Will your child join us for Breakfast Bunch?
*
Yes
No
Required
Is your child allergic to any food/medication?
*
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No
Required
If allergic, please explain below
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I give permission for my child to be photographed during VBS at Second Congregational Church. I understand that the photos may be used to keep a journal of activities and/or to share on Second Congregational social media channels but my child's identity will not be disclosed.
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