2019 Woods Chapel VBS Registration
Event Date & Time: July 15th - 18th, 2019 (6:00pm - 8:00pm)
*** Please arrive at 5:30 on Monday July 15th ***

Event Address: 175 AR-230, Brookland, AR 72417

Contact us at (870) 243-0722 or woodschapelgeneralbaptist@gmail.com

Child's Name: (one form per child) *
Your answer
Grade Completed: *
Child's Birthday: *
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Parent/Guardian Name *
Your answer
Home Address: *
Your answer
Home Phone: *
Your answer
Alternate Phone:
Your answer
Emergency Contact & Relationship to Child: *
Your answer
Emergency Contact's Phone Number: *
Your answer
Emergency Contact's Alternate Phone Number:
Your answer
Food Allergies: *
Food Allergies (if yes, please list):
Your answer
Medical Concerns *
Medical Concerns (If Yes, please list):
Your answer
Siblings Attending VBS (Names and Ages)
Your answer
Person(s)/Name(s) & Phone Number(s) who may pick up the child: *
Your answer
Transportation Needed: *
I give permission for Woods Chapel Baptist Church to use photos/videos of my child taken at Vacation Bible School to be used to help bring to life and tell the story of Woods Chapel's Ministries. *
Parent/Guardian Signature & Date: *
Your answer
By completing and submitting this form, you give permission for your child to participate in Woods Chapel Baptist Church Vacation Bible School. In the event of a medical emergency, you give your permission to the staff of Woods Chapel to seek medical attention. To accept, please check the box. *
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