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Green Run Baptist Church- VBS
June 20th-24th, 2022
6pm-8:30 pm
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1) Parent Name(s)
*
Your answer
2) Child's Name (First and Last)
*
Your answer
3) Child's Age
*
Choose
4-5
6-7
8-9
10-12
4) Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
*
Your answer
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)
Your answer
6) Child #2 Age
Choose
4-5
6-7
8-9
10-12
7) Child #2 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
Your answer
8) Child #3 Name (First and last)
Your answer
9) Child #3 Age
Choose
4-5
6-7
8-9
10-12
10) Child #3 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
Your answer
11) Child #4 Name (First and last)
Your answer
12) Child #4 Age
Choose
4-5
6-7
8-9
10-12
13) Child #4 Are there any allergy concerns? If so, please list them here. If there are no allergies, type "no".
Your answer
Communication and Permission
15) Parent/Guardian's Contact Phone Number
*
Your answer
16) Parent/Guardian's Street Address
*
Your answer
17) Parent/Guardian's Email Address
*
Your answer
18) Authorized PickUp- Please list any adults that have your permission to pick up your child(ren) from GRBC.
*
Your answer
19) I give permission for my child to be photographed and/or videotaped at the site and during program functions.
*
I agree
I disagree
20) I would like Green Run Baptist Church to contact me about other events they have after Vacation Bible School.
*
Yes
No
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