Green Run Baptist Church- VBS
June 20th-24th, 2022
6pm-8:30 pm
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1) Parent Name(s) *
2) Child's Name (First and Last) *
3) Child's Age *
4) Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no". *
Additional Children
If you have additional children that you wish to register, please fill out questions 5-13 as needed. If you are only registering one child, please proceed to question 14.

5) Child #2 Name (First and last)
6) Child #2 Age
7) Child #2 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
8) Child #3 Name (First and last)
9) Child #3 Age
10) Child #3 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
11) Child #4 Name (First and last)
12) Child #4 Age
13) Child #4 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
Communication and Permission
15) Parent/Guardian's Contact Phone Number *
16) Parent/Guardian's Street Address *
17) Parent/Guardian's Email Address *
18) Authorized PickUp- Please list any adults that have your permission to pick up your child(ren) from GRBC. *
19) I give permission for my child to be photographed and/or videotaped at the site and during program functions. *
20) I would like Green Run Baptist Church to contact me about other events they have after Vacation Bible School. *
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