VBS Registration
7/2/18-7/6/18
Seaside Christian Academy
12637 Ocean Gateway A, Ocean City, MD 21842
Please answer each question below.
Child's Name *
Your answer
Parent/ Guardian Name *
Your answer
Address (Street Address, City, State, Zip Code) *
Your answer
Primary Phone Number *
Your answer
Alternate Phone Number
Your answer
Email
Your answer
Age/ Birthdate *
Your answer
Last Grade Completed in School *
Medical Information (Medical or other information we need to know about your child. Please include any food allergies. If none, please type n/a.) *
Your answer
Emergency Contact #1 (Name and Number) *
Your answer
Emergency Contact #2 (Name and Number) *
Your answer
Who may pick up your child at the end of VBS? (first and last name(s) please) *
Your answer
May we have permission to photograph your child? *
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