GALACTIC STARVEYORS VBS REGISTRATION
We are excited for you to join us for our Vacation Bible School this year.
Child's Name (Last, First)
Your answer
Birthdate
MM
/
DD
/
YYYY
Age of Child
Grade of Child
Select the grade your child most recently completed.
List any Allergies (This Is Important)
Your answer
Parent / Guardian's Name (Last, First)
Your answer
Street Address
Your answer
City, State and Zip Code
Your answer
Contact Phone Number
Your answer
E-mail
Your answer
Emergency Contact Name (If Different From Parent / Guardian)
Your answer
Emergency Contact Number (If Different From Parent / Guardian)
Your answer
Please list ALL adults permitted to pick up children
Your answer
Does this child attend Sunday School?
If you are visiting our church, what church do you attend?
Your answer
Photo and Video Consent
During the week of VBS we take photos or videos of the children that attend. Some of these photos and videos may be displayed on the church website or other social media avenues. By registering your child for VBS, you are giving us permission to take photos and videos of your child and publish them on our church website and / or social media.
Submit
Never submit passwords through Google Forms.
This form was created inside of Northside Baptist Church. Report Abuse - Terms of Service - Additional Terms