Time Lab VBS Registration Form
Join us for Time Lab VBS! July 15-19 6-8:30 PM. Please use this form to register your child for Time Lab VBS at Our Father's House. Please complete one form for each child that you are registering.
Email address *
Child's Last Name
Your answer
Child's First Name *
Your answer
Child's Gender *
Child's Date of Birth *
MM
/
DD
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YYYY
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone Number *
Your answer
Mother's Name
Your answer
Mother's Cell Phone Number
Your answer
Father's Name
Your answer
Father's Cell Phone Number
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Additional people authorized to pick up child:
Your answer
Are there any allergies/medical conditions we need to be aware of?
Your answer
I am a: *
Do you have a home church? If yes, please list:
Your answer
Do you plan to attend the family service on July 22nd?
T-Shirt Size (Every child will receive a VBS t-shirt, we are asking for a $7 donation per shirt) *
Additional information you would like us to know about your child:
Your answer
I give my consent that my child may appear in any photography and videos while participating in the VBS experience at Our Father's House Asembly of God. I understand that these pictures and videos are the property of Our Father's House Assembly of God. *
Parent/Guardian Signature (please type your name below)
Your answer
A copy of your responses will be emailed to the address you provided.
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