In the Wild Vacation Bible School
Tuesday, July 9th - Saturday, July 13 from 6:00 p.m. - 8:30 p.m.
Email address *
Child's Name *
Your answer
Child's Age *
Your answer
Sex *
Child's Date of Birth *
MM
/
DD
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YYYY
Last grade completed in school if applicable *
Parent Name(s) *
Your answer
Parent Phone Number *
Your answer
Complete Home Address *
Your answer
Allergies or Special Needs
Your answer
Emergency Contact Name and Phone Number *
Your answer
Do we have permission to photograph your child? *
Required
May we post your child's photo on our Facebook page (no names) so you can see what they have been up to? *
Do you authorize North Park Wesleyan Church and their staff to administer first aid if needed and consent to emergency medical care if you are unavailable to give consent. Every effort will be made to contact you prior to any emergency medical care. *
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