VBS REGISTRATION
Please fill out one for each child that you are registering
Child's Name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Mailing Address (if different)
Your answer
Home Phone: *
Your answer
Cell Phone: *
Your answer
Work Phone:
Your answer
Date of Birth: *
Your answer
Last grade completed in school *
Your answer
Emergency Contact & Number: *
Your answer
Medical Information:
Medical or other information we need to know about your child. Please include any allergies to food or medication
Medical (if none please put "None") *
Your answer
Food Allergies / Medication (if none, please put "None") *
Your answer
Dismissal Information:
Who may pick up your child / children at the end of each VBS day?
*
Your answer
Other Information:
Do you attend church? If so where?
Your answer
If you are visiting our church, who are you a guest of?
Your answer
May we have permission to photograph your child? *
May we have permission to use your child's photograph in church publication for the purpose of promotion? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms