VBS 2019
Parent’s Names? *
Your answer
What is your address? *
Your answer
What is your cell phone number? *
Your answer
What is your email? *
Your answer
1st child’s full name and age? *
Your answer
2nd child’s full name and age?
Your answer
3rd child’s full name and age?
Your answer
Emergency contact name? *
Your answer
Emergency contact phone number? *
Your answer
Is anyone authorized to pick up your child(ren)? *
Full name and phone number of authorized person(s) to pick up your child(ren)?
Your answer
Dietary restrictions or severe allergies/ other info we need to know?
Your answer
Consent for Medical Treatment: Do you give the Acworth Grace Fellowship church consent to treat your child(ren) medically, if necessary? *
Photo Release Waiver: I give my permission for the Acworth Grace Fellowship Church to use my child(ren’s) photo(s) on the website or social media platforms to record or celebrate this event. *
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